Providence Health & Services - Oregon

NPI #1235479643 in Portland, Oregon

Provider Information

NPI Number
1235479643
Entity Type
Organization
Organization Name
Providence Health & Services - Oregon
Primary Specialty
Internal Medicine - Sports Medicine
Enumeration Date
Feb 21, 2013
Last Updated
Jul 4, 2025

Practice Location

Address
909 SW 18TH AVE
State
Oregon
ZIP Code
97205-1705
Phone
(503) 962-1946

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Internal Medicine
Clinic/Center
Internal Medicine - Sports MedicineSports Medicine

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