Providence Health & Services - Oregon

NPI 1114015971

Information of Providence Health & Services - Oregon

The NPI 1114015971 is an Organization type. NPI No 1114015971 belongs to Providence Health & Services - Oregon. Providence Health & Services - Oregon specializes in Anatomic Pathology & Clinical Pathology. is practising at 9205 Sw Barnes Rd, Portland, Oregon 97225. You can also contact him via phone number (503) 215-4323.

Practice address located

  • 9205 Sw Barnes Rd
  • Portland, Oregon 97225
  • (503) 215-4323
  • (503) 215-4323

Mailling address located

  • Po Box 3396
  • Portland, Oregon 97208
  • (503) 215-4323
  • (503) 215-0297
Providence Health & Services - Oregon is PECOS enrolled.
NPI No 1114015971
Primary Taxonomy
Authorized Official
Specialty of the provider
PrimaryTaxonomy CodeClassificationLicense NumberLicense State
No207ZP0102XAnatomic Pathology & Clinical Pathologyn/an/a
No207P00000XEmergency Medicinen/an/a
No207U00000XNuclear Medicinen/an/a
No207R00000XInternal Medicinen/an/a
No207V00000XObstetrics & Gynecologyn/an/a
No207L00000XAnesthesiologyn/an/a
Yes282N00000XGeneral Acute Care Hospitaln/an/a
Identifier for this provider
StateIdentifierTypeIssuer
OR052000000001OtherPROVIDENCE HEALTH PLAN
OR10051OtherWA DEPT OF LABOR CLINIC
OR138000400OtherREGENCE HOSPITAL NUMBER
OR193805Medicaidn/a
OR194078600OtherUS DEPT OF LABOR WC
OR262286OtherMEDICAID BHS OUTPT
OR3342067OtherWASHINGTON MEDICAID
OR380004Medicare Oscar/Certificationn/a
OR5988OtherWA DEPT OF LABOR HOSPITAL
ORCG2504OtherRAILROAD MEDICARE
ORRS0004OtherPART B MEDICARE PTAN
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