Providence Health & Services - Oregon

NPI #1093976243 in Medford, Oregon

Provider Information

NPI Number: 1093976243
Entity Type: Organization
Organization Name: Providence Health & Services - Oregon
Subpart: Yes (part of a larger organization)
Parent Organization: PROVIDENCE HEALTH & SERVICES - OREGON
Primary Specialty: Clinic/Center
Enumeration Date: Jun 20, 2008
Last Updated: May 29, 2025

Practice Location

Address: 1111 CRATER LAKE AVE
City: Medford
State: Oregon
ZIP Code: 97504-6241
Phone: (541) 732-5250

Authorized Official

Name: DONALD W ANDERSON JR.
Title: ASSISTANT SECRETARY OF ENROLLMENTS
Phone: (425) 358-9786

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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