Providence Medical Group
LBN: Providence Health & Services Oregon
Providence Medical Group is an health care organization with primary practice located at 4805 Ne Glisan St Ste 11N , Portland OR 97213-2933. The organization recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology & Oncology, Allopathic & Osteopathic Physicians / Hepatology, Allopathic & Osteopathic Physicians / Medical Oncology, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Oncology, Ambulatory Health Care Facilities / Clinic/Center. Allopathic & Osteopathic Physicians / Medical Oncology is the primary health care specialty.
Providence Health & Services Oregon can be contacted via phone (503) 215-8650, or through Anderson, Donald Wayne via phone (425) 525-5392.
Contact Information
Primary practice address
4805 Ne Glisan St Ste 11N
Portland OR 97213-2933
Phone: (503) 215-8650
Fax: (503) 215-8653
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | ||
| Allopathic & Osteopathic Physicians / Hepatology | 207RI0008X | ||
| Allopathic & Osteopathic Physicians / Medical Oncology | 207RX0202X | ||
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | ||
| Allopathic & Osteopathic Physicians / Surgical Oncology | 2086X0206X | ||
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X |
Profile Details
| NPI number | 1801010004 |
|---|---|
| LBN Legal business name | Providence Health & Services Oregon |
| DBA Doing business as | Providence Medical Group |
| Authorized official | Anderson, Donald Wayne |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 12th, 2007 |
| Last updated | May 28th, 2024 - about 6 months 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 | 1801010004 | NPPES |
| Oregon | MEDICAID | 274461 |
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