| Providence Medical Group Canby Immediate Care | |
|
200 S Hazel Dell Way Canby OR 97013-7829 | |
| (503) 263-9500 | |
| Not Available |
| Full Name | Providence Medical Group Canby Immediate Care |
|---|---|
| Speciality | Clinic/center |
| Location | 200 S Hazel Dell Way, Canby, Oregon |
| Authorized Official Name and Position | Donald Wayne Anderson (ASST SEC FOR ENROLLMENT/DIR REIMB S) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Group Canby Immediate Care Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Medical Group Canby Immediate Care 200 S Hazel Dell Way Canby OR 97013-7829 Ph: (503) 263-9500 |
| NPI Number | 1245567817 |
|---|---|
| Provider Enumeration Date | 11/03/2009 |
| Last Update Date | 04/16/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245567817 | NPI | - | NPPES |
| 500617241 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Health Practitioner Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 143 Nw 4th Ave, Canby, OR 97013 Phone: 503-263-6611 Fax: 503-266-5674 | |
Neighborhood Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 178 Sw 2nd Ave, Canby, OR 97013 Phone: 503-416-4547 Fax: 503-416-4553 | |
Canby Healthcare Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 703 Se 1st Ave, Canby, OR 97013 Phone: 503-266-7686 Fax: 503-266-7382 | |
Canby Healthcare Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 703 Se 1st Ave, Canby, OR 97013 Phone: 503-266-7686 Fax: 503-266-7382 | |
Providence Medical Group Canby Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 S Hazel Dell Way, Canby, OR 97013 Phone: 503-263-9500 Fax: 503-263-1383 | |
Trent B. Warren, M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1507 Se 3rd Ct, Canby, OR 97013 Phone: 503-266-5127 Fax: 503-266-3821 |