Providence Health & Services Oregon

NPI #1245330380 in Clackamas, Oregon

Provider Information

NPI Number: 1245330380
Entity Type: Organization
Organization Name: Providence Health & Services Oregon
Primary Specialty: Family Medicine
Enumeration Date: Sep 25, 2006
Last Updated: Jun 20, 2025

Practice Location

Address: 9290 SE SUNNYBROOK BLVD
Address 2: SUITE 120
City: Clackamas
State: Oregon
ZIP Code: 97015
Phone: (503) 215-2110

Authorized Official

Name: DONALD WAYNE ANDERSON JR.
Title: ASST CORP SECRETARY FOR ENROLLMENTS
Phone: (425) 358-9786

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X
Family Medicine	207Q00000X	Primary

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