Providence Medical Group
LBN: Providence Health & Services - Oregon
Providence Medical Group is an health care organization with primary practice located at 9427 Sw Barnes Rd Ste 395 , Portland OR 97225-6652. 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
9427 Sw Barnes Rd Ste 395
Portland OR 97225-6652
Phone: (503) 216-1280
Fax: (503) 216-1288
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology | 2084N0402X | ||
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X |
Profile Details
| NPI number | 1316125149 |
|---|---|
| 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 | Feb 4th, 2008 |
| Last updated | May 22nd, 2024 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316125149 | NPPES |
| Oregon | MEDICAID | 279056 |
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