Providence Medical Group Milwaukie Family Medicine

LBN: Providence Health & Services - Oregon
Providence Medical Group Milwaukie Family Medicine is an health care organization with primary practice located at 10330 Se 32Nd Ave Suite 205, Milwaukie OR 97222-6594. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Clinic/Center, Physician Assistants & Advanced Practice Nursing Providers / Family. Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty. Providence Health & Services - Oregon can be contacted via phone (503) 513-8950, or through Anderson, Donald W via phone (425) 525-5392.

Contact Information

Primary practice address
10330 Se 32Nd Ave Suite 205 Milwaukie OR 97222-6594
Phone: (503) 513-8950
Fax: (503) 513-8951
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Donald W
Phone: (425) 525-5392

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1699870873
LBN Legal business name Providence Health & Services - Oregon
DBA Doing business as Providence Medical Group Milwaukie Family Medicine
Authorized official Anderson, Donald W
Entity Organization
Organization subpart 1 No
Enumeration date Sep 13th, 2006
Last updated Sep 24th, 2020 - 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 1699870873 NPPES
Oregon MEDICAID 022861

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