| Providence Medical Group Orenco | |
|
5555 Ne Elam Young Pkwy Hillsboro OR 97124-6452 | |
| (503) 216-1600 | |
| Not Available |
| Full Name | Providence Medical Group Orenco |
|---|---|
| Speciality | Clinic/center |
| Location | 5555 Ne Elam Young Pkwy, Hillsboro, Oregon |
| Authorized Official Name and Position | Donald W Anderson (DIR REIMB REG STRAT/ASST SEC ENROLL) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Group Orenco Po Box 3158 Portland OR 97208-3158 Ph: (503) 215-6494 | Providence Medical Group Orenco 5555 Ne Elam Young Pkwy Hillsboro OR 97124-6452 Ph: (503) 216-1600 |
| NPI Number | 1003916354 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 07/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003916354 | NPI | - | NPPES |
| 227593 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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