Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic | |
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice |
| NPI Number | 1649344458 |
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| LBN Legal business name | PROVIDENCE HEALTH & SERVICES OREGON | ||||||||||||||||||||
| Authorized official | DONALD ANDERSON - (ASSISTANT SECRETARY ENROLLMENTS) | ||||||||||||||||||||
| Entity | Organization | ||||||||||||||||||||
| Organization subpart 1 | Yes | ||||||||||||||||||||
| Enumeration date | 11/20/2006 | ||||||||||||||||||||
| Last updated | 04/29/2025 - More than a year ago | ||||||||||||||||||||
| Identifiers |
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