OrganizationActive
Providence Health & Services - Oregon
NPI 1992882500 · Clinic/Center · Phoenix, OR
Provider details
- NPI number
- 1992882500
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Providence Health & Services - Oregon
- Organization subpart
- Yes
- Authorized official
- Donald Anderson, Asst Secretary for Enrollment(425) 525-5392
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
205 N Phoenix Rd
Suite a
Phoenix, OR 97535-9104
Phone: (541) 732-5760
Fax: (541) 732-3406
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 3158
Portland, OR 97208-3158
Other names (DBA / former)
- Doing business as
- Providence Medical Group South
Registry dates
- Enumerated
- 2006-11-01
- Last updated
- 2025-11-19
- Certified
- 2025-11-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.