| Providence Health & Services Oregon | |
|
1511 Division St Ste 101 Oregon City OR 97045-1589 | |
| (503) 722-3705 | |
| (503) 722-3750 |
| Full Name | Providence Health & Services Oregon |
|---|---|
| Speciality | Internal Medicine |
| Location | 1511 Division St Ste 101, Oregon City, Oregon |
| Authorized Official Name and Position | Donald Wayne Anderson (ASST SECRETARY FOR ENROLLMENTS) |
| Authorized Official Contact | 4253589786 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Health & Services Oregon Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Health & Services Oregon 1511 Division St Ste 101 Oregon City OR 97045-1589 Ph: (503) 722-3705 |
| NPI Number | 1992138309 |
|---|---|
| Provider Enumeration Date | 08/21/2013 |
| Last Update Date | 05/05/2025 |
| Certification Date | 05/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992138309 | NPI | - | NPPES |
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