Providence Medical Group
LBN: Providence Health & Services - Oregon
Providence Medical Group is an health care organization with primary practice located at 12442 Sw Scholls Ferry Rd Suite 100, Tigard OR 97223-0803. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Clinic/Center. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Providence Health & Services - Oregon can be contacted via phone (503) 216-9900, or through Anderson, Donald Wayne via phone (425) 525-5392.
Contact Information
Primary practice address
12442 Sw Scholls Ferry Rd Suite 100
Tigard OR 97223-0803
Phone: (503) 216-9900
Fax: (503) 216-9266
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X |
Profile Details
| NPI number | 1396836276 |
|---|---|
| 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 | Sep 27th, 2006 |
| Last updated | Jul 11th, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396836276 | NPPES |
| Oregon | MEDICAID | 063680 |
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