| Providence Health & Services - Oregon | |
|
920 Royal Ave Medford OR 97504-6169 | |
| (541) 732-8400 | |
| (541) 732-8401 |
| Full Name | Providence Health & Services - Oregon |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 920 Royal Ave, Medford, Oregon |
| Authorized Official Name and Position | Donald W Anderson (ASSISTANT SECRETARY 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: (503) 215-6494 | Providence Health & Services - Oregon 920 Royal Ave Medford OR 97504-6169 Ph: (541) 732-8400 |
| NPI Number | 1063705887 |
|---|---|
| Provider Enumeration Date | 05/26/2011 |
| Last Update Date | 05/12/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063705887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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