Providence Medical Group
LBN: Providence Health & Services - Oregon
Providence Medical Group is an health care organization with primary practice located at 5330 Ne Glisan St Suite 100, Portland OR 97213-3069. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Urgent Care. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty.
Providence Health & Services - Oregon can be contacted via phone (503) 215-9706, or through Anderson, Donald W via phone (425) 525-5392.
Contact Information
Primary practice address
5330 Ne Glisan St Suite 100
Portland OR 97213-3069
Phone: (503) 215-9706
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | ||
| Ambulatory Health Care Facilities / Urgent Care | 261QU0200X |
Profile Details
| NPI number | 1841466141 |
|---|---|
| LBN Legal business name | Providence Health & Services - Oregon |
| DBA Doing business as | Providence Medical Group |
| Authorized official | Anderson, Donald W |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 6th, 2008 |
| Last updated | Jun 13th, 2024 - about 3 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 | 1841466141 | NPPES |
| Oregon | MEDICAID | 500400318 |
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