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Contact Information

PROVIDENCE HEALTH & SERVICES OREGON
540 S MAIN ST
MOUNT ANGEL, OR97362-9540
 Phone: 503-845-6841
 Fax: 503-845-9229
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH & SERVICES OREGON

NPI Number 1417978164
LBN Legal business name PROVIDENCE HEALTH & SERVICES OREGON
Authorized official DONALD ANDERSON - (ASSISTANT SECRETARY OF ENROLLMENTS)
Entity Organization
Organization subpart 1 No
Enumeration date 07/21/2006
Last updated 05/15/2025 - More than a year ago
Identifiers
OR License # 385018
OR Medicaid 800006
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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