Providence Medical Group Tanasbourne Immediate Care

LBN: Providence Health & Services Oregon
Providence Medical Group Tanasbourne Immediate Care is an health care organization with primary practice located at 18610 Nw Cornell Rd Suite 101, Hillsboro OR 97124. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Providence Health & Services Oregon can be contacted via phone (503) 216-9360, or through Anderson, Donald Wayne via phone (425) 525-5392.

Contact Information

Primary practice address
18610 Nw Cornell Rd Suite 101 Hillsboro OR 97124
Phone: (503) 216-9360
Fax: (503) 216-9363
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Donald Wayne
Phone: (425) 525-5392

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1700987401
LBN Legal business name Providence Health & Services Oregon
DBA Doing business as Providence Medical Group Tanasbourne Immediate Care
Authorized official Anderson, Donald Wayne
Entity Organization
Organization subpart 1 No
Enumeration date Sep 26th, 2006
Last updated Jul 9th, 2018 - about 8 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 1700987401 NPPES
Oregon MEDICAID 022870

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