| Providence Health & Services Oregon | |
|
10150 Se 32nd Ave Milwaukie OR 97222-6516 | |
| (503) 513-8336 | |
| Not Available |
| Full Name | Providence Health & Services Oregon |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 10150 Se 32nd Ave, Milwaukie, Oregon |
| Authorized Official Name and Position | Donald W Anderson (ASSISTANT SECRETARY ENROLLMENTS) |
| Authorized Official Contact | 4253589786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Health & Services Oregon Po Box 31001-4199 Pasadena CA 91110-4199 Ph: () - | Providence Health & Services Oregon 10150 Se 32nd Ave Milwaukie OR 97222-6516 Ph: (503) 513-8336 |
| NPI Number | 1659751360 |
|---|---|
| Provider Enumeration Date | 06/08/2015 |
| Last Update Date | 04/29/2025 |
| Certification Date | 04/21/2025 |
| Medicare PECOS PAC ID | 6103728753 |
|---|---|
| Medicare Enrollment ID | O20150902003075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659751360 | NPI | - | NPPES |
| 500720306 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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