Providence Medical Group

LBN: Providence Health & Services - Oregon
Providence Medical Group is an health care organization with primary practice located at 830 Ne 47Th Ave , Portland OR 97213-2212. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology, Ambulatory Health Care Facilities / Clinic/Center. Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty. Providence Health & Services - Oregon can be contacted via phone (503) 216-1280, or through Anderson, Donald Wayne via phone (425) 525-5392.

Contact Information

Primary practice address
830 Ne 47Th Ave Portland OR 97213-2212
Phone: (503) 216-1280
Fax: (503) 216-1288
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Donald Wayne
Phone: (425) 525-5392

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1033535463
LBN Legal business name Providence Health & Services - Oregon
DBA Doing business as Providence Medical Group
Authorized official Anderson, Donald Wayne
Entity Organization
Organization subpart 1 No
Enumeration date Mar 10th, 2014
Last updated Jan 18th, 2024 - about 11 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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