Providence Health & Services - Oregon

NPI #1770723017 in Tigard, Oregon

Provider Information

NPI Number: 1770723017
Entity Type: Organization
Organization Name: Providence Health & Services - Oregon
Subpart: Yes (part of a larger organization)
Parent Organization: PROVIDENCE HEALTH & SERVICES - OREGON
Primary Specialty: Dermatology
Enumeration Date: Feb 26, 2009
Last Updated: Jul 1, 2025

Practice Location

Address: 18040 SW LOWER BOONES FERRY RD
Address 2: SUITE 100
City: Tigard
State: Oregon
ZIP Code: 97224-7215
Phone: (503) 216-0700

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X
Dermatology	207N00000X	Primary

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