Providence Oral Head And Neck Clinic

LBN: Providence Health & Services - Oregon
Providence Oral Head And Neck Clinic is an health care organization with primary practice located at 4805 Ne Glisan St Suite 6N50, Portland OR 97213-2933. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, 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) 215-3053, or through Freeman, Keenan via phone (503) 893-6524.

Contact Information

Primary practice address
4805 Ne Glisan St Suite 6N50 Portland OR 97213-2933
Phone: (503) 215-3053
Fax: (503) 215-3037
Website:
Map and Directions
Authorized official contact:
Name: Freeman, Keenan
Phone: (503) 893-6524

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1407109937
LBN Legal business name Providence Health & Services - Oregon
DBA Doing business as Providence Oral Head And Neck Clinic
Authorized official Freeman, Keenan
Entity Organization
Organization subpart 1 No
Enumeration date Oct 22nd, 2012
Last updated Oct 22nd, 2012 - about 13 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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