| Providence Health & Services - Oregon | |
|
827 Spring St Medford OR 97504-6111 | |
| (541) 732-8360 | |
| (541) 732-8361 |
| Full Name | Providence Health & Services - Oregon |
|---|---|
| Speciality | Clinic/center |
| Location | 827 Spring St, Medford, Oregon |
| Authorized Official Name and Position | Donald Wayne Anderson (ASSISTANT SECRETARY ENROLLMENT) |
| 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: (541) 732-8360 | Providence Health & Services - Oregon 827 Spring St Medford OR 97504-6111 Ph: (541) 732-8360 |
| NPI Number | 1699917781 |
|---|---|
| Provider Enumeration Date | 04/03/2009 |
| Last Update Date | 11/19/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699917781 | NPI | - | NPPES |
| 500613379 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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