Providence Medical Group Sherwood
LBN: Providence Health & Services - Oregon
Providence Medical Group Sherwood is an health care organization with primary practice located at 16770 Sw Edy Rd Suite 102, Sherwood OR 97140-9679. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry, 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) 216-9600, or through Anderson, Donald Wayne via phone (425) 525-5392.
Contact Information
Primary practice address
16770 Sw Edy Rd Suite 102
Sherwood OR 97140-9679
Phone: (503) 216-9600
Fax: (503) 216-9650
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | ||
| Allopathic & Osteopathic Physicians / Geriatric Psychiatry | 2084P0805X | ||
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X |
Profile Details
| NPI number | 1184729329 |
|---|---|
| LBN Legal business name | Providence Health & Services - Oregon |
| DBA Doing business as | Providence Medical Group Sherwood |
| Authorized official | Anderson, Donald Wayne |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 13th, 2006 |
| Last updated | Apr 16th, 2021 - about 3 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184729329 | NPPES |
| Oregon | MEDICAID | 500400324 | |
| Oregon | MEDICAID | 022851 |
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