Providence Health & Services - Oregon

NPI #1063705887 in Medford, Oregon

Provider Information

NPI Number: 1063705887
Entity Type: Organization
Organization Name: Providence Health & Services - Oregon
Subpart: Yes (part of a larger organization)
Parent Organization: PROVIDENCE HEALTH & SERVICES - OREGON
Primary Specialty: Internal Medicine
Enumeration Date: May 26, 2011
Last Updated: Nov 19, 2025

Practice Location

Address: 920 ROYAL AVE
City: Medford
State: Oregon
ZIP Code: 97504-6169
Phone: (541) 732-8400

Authorized Official

Name: DONALD WAYNE ANDERSON JR.
Title: ASSISTANT SECRETARY ENROLLMENT
Phone: (425) 358-9786

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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