Providence Medical Group West Linn

LBN: Providence Health & Services - Oregon
Providence Medical Group West Linn is an health care organization with primary practice located at 17550 Provost St Ste 201 , Lake Oswego OR 97034-5199. 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) 513-3350, or through Anderson, Donald W via phone (425) 525-5392.

Contact Information

Primary practice address
17550 Provost St Ste 201 Lake Oswego OR 97034-5199
Phone: (503) 513-3350
Fax: (503) 513-3355
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Donald W
Phone: (425) 525-5392

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1568793313
LBN Legal business name Providence Health & Services - Oregon
DBA Doing business as Providence Medical Group West Linn
Authorized official Anderson, Donald W
Entity Organization
Organization subpart 1 No
Enumeration date Jan 19th, 2010
Last updated Jul 31st, 2020 - about 6 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 1568793313 NPPES
Oregon MEDICAID 500672536

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