Providence Medical Group Scholls

LBN: Providence Health & Services - Oregon
Providence Medical Group Scholls is an health care organization with primary practice located at 12442 Sw Scholls Ferry Rd Suite 100, Tigard OR 97223-3396. 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) 216-9200, or through Anderson, Donald Wayne via phone (425) 525-5392.

Contact Information

Primary practice address
12442 Sw Scholls Ferry Rd Suite 100 Tigard OR 97223-3396
Phone: (503) 216-9200
Fax: (503) 216-9220
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 1093815243
LBN Legal business name Providence Health & Services - Oregon
DBA Doing business as Providence Medical Group Scholls
Authorized official Anderson, Donald Wayne
Entity Organization
Organization subpart 1 No
Enumeration date Sep 25th, 2006
Last updated Jun 17th, 2021 - 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 1093815243 NPPES
Oregon MEDICAID 063680

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