| 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 | Internal Medicine |
| Location | 200 S Hazel Dell Way, Canby, Oregon |
| Authorized Official Name and Position | Donald Wayne 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 Medical Group Canby Immediate Care Po Box 31001-4180 Pasadena CA 91110-4180 | 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 | 06/20/2025 |
| Certification Date | 06/20/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245567817 | NPI | - | NPPES |
| 500617241 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 261Q00000X | Clinic/center | () | Secondary |
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: 227 Nw 3rd 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 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 |