Providence Medical Group Sunnyside

LBN: Providence Health & Services Oregon
Providence Medical Group Sunnyside is an health care organization with primary practice located at 9290 Se Sunnybrook Blvd Suite 120, Clackamas OR 97015. 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) 215-2110, or through Anderson, Donald Wayne via phone (425) 525-5392.

Contact Information

Primary practice address
9290 Se Sunnybrook Blvd Suite 120 Clackamas OR 97015
Phone: (503) 215-2110
Fax: (503) 215-2115
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 1245330380
LBN Legal business name Providence Health & Services Oregon
DBA Doing business as Providence Medical Group Sunnyside
Authorized official Anderson, Donald Wayne
Entity Organization
Organization subpart 1 No
Enumeration date Sep 25th, 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 1245330380 NPPES
Oregon MEDICAID 043997

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