| Providence Health & Services - Oregon | |
|
4805 Ne Glisan St Ste 6n60 Portland OR 97213-2933 | |
| (503) 215-2075 | |
| (503) 215-2077 |
| Full Name | Providence Health & Services - Oregon |
|---|---|
| Speciality | Obstetrics & Gynecology |
| Location | 4805 Ne Glisan St, Portland, 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: () - | Providence Health & Services - Oregon 4805 Ne Glisan St Ste 6n60 Portland OR 97213-2933 Ph: (503) 215-2075 |
| NPI Number | 1013217975 |
|---|---|
| Provider Enumeration Date | 10/26/2010 |
| Last Update Date | 05/16/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013217975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Primary |
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