Providence Health & Services - Oregon

NPI #1790107050 in Clackamas, Oregon

Provider Information

NPI Number: 1790107050
Entity Type: Organization
Organization Name: Providence Health & Services - Oregon
Primary Specialty: Dermatology
Enumeration Date: Jan 6, 2014
Last Updated: Jul 1, 2025

Practice Location

Address: 9290 SE SUNNYBROOK BLVD
Address 2: SUITE 120
City: Clackamas
State: Oregon
ZIP Code: 97015-6802
Phone: (503) 215-9080

Authorized Official

Name: DONALD WAYNE ANDERSON JR.
Title: ASST SEC ENROLLMENT
Phone: (425) 358-9786

Specialties & Taxonomy Codes

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

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