Providence Child Center

LBN: Providence Health & Services-Oregon
Providence Child Center is an health care organization with primary practice located at 830 Ne 47Th Ave , Portland OR 97213-2212. The organization recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, Nursing & Custodial Care Facilities / Nursing Care, Pediatric, Respite Care Facility / Respite Care, Physical Disabilities, Child. Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility is the primary health care specialty. Providence Health & Services-Oregon can be contacted via phone (503) 215-2400, 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) 215-2400
Fax: (503) 215-0660
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Donald Wayne
Phone: (425) 525-5392

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X 1700250565 Oregon
Nursing & Custodial Care Facilities / Nursing Care, Pediatric 3140N1450X 1035453259 Oregon
Respite Care Facility / Respite Care, Physical Disabilities, Child 385HR2065X 1035453259 Oregon

Profile Details

NPI number 1376625137
LBN Legal business name Providence Health & Services-Oregon
DBA Doing business as Providence Child Center
Authorized official Anderson, Donald Wayne
Entity Organization
Organization subpart 1 No
Enumeration date Oct 20th, 2006
Last updated Aug 28th, 2019 - about 5 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 1376625137 NPPES
Oregon Other 1035453259 DEPT OF HUMAN SVCS
Oregon MEDICAID 807297 DEPT OF HUMAN SVCS
Oregon MEDICAID 4570701 DEPT OF HUMAN SVCS

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