Providence Medical Group Oregon City Spine Center

LBN: Providence Health & Services - Oregon
Providence Medical Group Oregon City Spine Center is an health care organization with primary practice located at 1510 Division St Ste 170, Oregon City OR 97045-1581. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Providence Health & Services - Oregon can be contacted via phone (503) 650-6288, or through Freeman, Keenan B via phone (503) 893-6524.

Contact Information

Primary practice address
1510 Division St Ste 170 Oregon City OR 97045-1581
Phone: (503) 650-6288
Fax: (503) 650-6884
Website:
Map and Directions
Authorized official contact:
Name: Freeman, Keenan B
Phone: (503) 893-6524

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1194057497
LBN Legal business name Providence Health & Services - Oregon
DBA Doing business as Providence Medical Group Oregon City Spine Center
Authorized official Freeman, Keenan B
Entity Organization
Organization subpart 1 No
Enumeration date Feb 11th, 2010
Last updated Sep 25th, 2013 - about 11 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 1194057497 NPPES
Oregon MEDICAID 500620086

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