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:
Map and Directions
Authorized official contact:
Name: Anderson, Donald Wayne
Phone: (425) 525-5392

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184729329 NPPES
Oregon MEDICAID 500400324
Oregon MEDICAID 022851

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