Providence Health & Services - Oregon is a
Family Medicine based in Lake Oswego, Oregon. Providence Health & Services - Oregon is licensed to practice in * (Not Available) (license number ) and their current practice location is
4004 Kruse Way Pl Ste 300, Lake Oswego, Oregon. It can be reached at their office (for appointments etc.) via phone at
(503) 216-1500.
NPI number for Providence Health & Services - Oregon is 1205937273 and their current mailing address is Po Box 3158, Portland, Oregon. Providence Health & Services - Oregon
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1205937273.
Healthcare Provider's Profile
| Full Name | Providence Health & Services - Oregon |
|---|
| Type | Facility |
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| Speciality | Family Medicine |
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| Location | 4004 Kruse Way Pl Ste 300, Lake Oswego, Oregon |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1205937273
- Provider Enumeration Date: 09/25/2006
- Last Update Date: 05/16/2025
Medical Identifiers
Medical identifiers for Providence Health & Services - Oregon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205937273 | NPI | - | NPPES |
| 241291 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Providence Health & Services - Oregon is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Providence Health & Services - Oregon
Po Box 3158,
Portland, OR 97208-3158
Ph: (503) 215-6494 | Providence Health & Services - Oregon
4004 Kruse Way Pl Ste 300,
Lake Oswego, OR 97035-2479
Ph: (503) 216-1500 |
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