National Provider Identifier Database

PROVIDENCE HEALTH SERVICES OREGON
Rural Health


Contact Information

PROVIDENCE HEALTH & SERVICES OREGON
727 S WAHANNA RD
SEASIDE, OR97138
Phone: 503-717-7000
Fax:
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X
Multi-Specialty 261QM1300X

* Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH & SERVICES OREGON

NPI Number 1649344458
Legal business name
LBN
PROVIDENCE HEALTH & SERVICES OREGON
Authorized official DONALD ANDERSON - (ASSISTANT SECRETARY ENROLLMENTS)
Entity Organization
Organization subpart Yes
Enumeration date 11/20/2006
Last updated 04/29/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • OR Medicaid: 000138
  • OR Other: 039607 MEDICAID CLINIC - 1500 BILLING
  • OR Other: C13774 RAILROAD MEDICARE
  • OR Other: 015560000 REGENCE BCBSO CLINIC #
  • OR Other: 7042567 WASHINGTON MEDICAID

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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