Providence Medical Group

LBN: Providence Health & Services - Oregon
Providence Medical Group is an health care organization with primary practice located at 9155 Sw Barnes Rd Ste 333, Portland OR 97225-6625. The organization recently has 8 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry, Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Allopathic & Osteopathic Physicians / Psychiatry is the primary health care specialty. Providence Health & Services - Oregon can be contacted via phone (503) 216-5102, or through Anderson, Donald W via phone (425) 525-5392.

Contact Information

Primary practice address
9155 Sw Barnes Rd Ste 333 Portland OR 97225-6625
Phone: (503) 216-5102
Fax: (503) 216-2485
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Donald W
Phone: (425) 525-5392

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X Oregon
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X Oregon
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X Oregon
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X Oregon

Profile Details

NPI number 1013192806
LBN Legal business name Providence Health & Services - Oregon
DBA Doing business as Providence Medical Group
Authorized official Anderson, Donald W
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 31st, 2007
Last updated Jun 13th, 2024 - about 6 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013192806 NPPES
Oregon MEDICAID 245786
Oregon MEDICAID 500601075

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