Providence Health & Services Oregon
LBN: Providence Health & Services Oregon
Providence Health & Services Oregon is an health care organization with primary practice located at 965 Ellendale Dr , Medford OR 97504-8215. The organization recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry, Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Adolescent and Children Mental Health. Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty.
Providence Health & Services Oregon can be contacted via phone (541) 732-6000, or through Anderson, Donald Wayne via phone (425) 525-5392.
Contact Information
Primary practice address
965 Ellendale Dr
Medford OR 97504-8215
Phone: (541) 732-6000
Fax: (541) 732-6005
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | ||
| Allopathic & Osteopathic Physicians / Geriatric Psychiatry | 2084P0805X | ||
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | ||
| Ambulatory Health Care Facilities / Adolescent and Children Mental Health | 261QM0855X |
Profile Details
| NPI number | 1568547503 |
|---|---|
| LBN Legal business name | Providence Health & Services Oregon |
| DBA Doing business as | |
| Authorized official | Anderson, Donald Wayne |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Oct 26th, 2006 |
| Last updated | Feb 14th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568547503 | NPPES |
| Oregon | MEDICAID | 288515 | |
| Oregon | Other | CG6801 |
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