Providence Medical Group Glisan Dermatology At Sunnyside

LBN: Providence Health & Services - Oregon
Providence Medical Group Glisan Dermatology At Sunnyside is an health care organization with primary practice located at 9290 Se Sunnybrook Blvd Suite 120, Clackamas OR 97015-6802. 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) 215-9080, or through Freeman, Keenan B via phone (503) 893-6524.

Contact Information

Primary practice address
9290 Se Sunnybrook Blvd Suite 120 Clackamas OR 97015-6802
Phone: (503) 215-9080
Fax: (503) 215-9099
Website:
Map and Directions
Authorized official contact:
Name: Freeman, Keenan B
Phone: (503) 893-6524

Health care specialties

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

Profile Details

NPI number 1790107050
LBN Legal business name Providence Health & Services - Oregon
DBA Doing business as Providence Medical Group Glisan Dermatology At Sunnyside
Authorized official Freeman, Keenan B
Entity Organization
Organization subpart 1 No
Enumeration date Jan 6th, 2014
Last updated Dec 30th, 2014 - about 12 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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