Providence Health & Services - Oregon

NPI #1194013144 in Battle Ground, Washington

Provider Information

NPI Number
1194013144
Entity Type
Organization
Organization Name
Providence Health & Services - Oregon
Primary Specialty
Family Medicine
Enumeration Date
Jul 12, 2011
Last Updated
Jun 20, 2025

Practice Location

Address
101 NW 12TH AVE
Address 2
SUITE 107
ZIP Code
98604-9141
Phone
(360) 666-4480

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Internal Medicine
Physician Assistant
Family Medicine

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