| Providence Health & Services - Oregon | |
|
12442 Sw Scholls Ferry Rd Suite 205 Tigard OR 97223-0804 | |
| (503) 216-9140 | |
| Not Available |
| Full Name | Providence Health & Services - Oregon |
|---|---|
| Speciality | Pediatrics |
| Location | 12442 Sw Scholls Ferry Rd, Tigard, Oregon |
| Authorized Official Name and Position | Donald W Anderson (ASSISTANT SECRETARY OF 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 31001-4180 Pasadena CA 91110-4180 Ph: () - | Providence Health & Services - Oregon 12442 Sw Scholls Ferry Rd Suite 205 Tigard OR 97223-0804 Ph: (503) 216-9140 |
| NPI Number | 1093135535 |
|---|---|
| Provider Enumeration Date | 04/23/2014 |
| Last Update Date | 06/20/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093135535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
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