Providence Medical Group is a Neurology Clinic in Portland, Oregon. This organization is also known as sub part of Providence Health & Services - Oregon. It is located at 9155 Sw Barnes Rd, Ste 333, Portland, OR and its contact number is 503-216-5102. The authorized person for Providence Medical Group is Mr. Donald W Anderson Jr.
who is Assistant Secretary Enrollment of the clinic and his/her contact number is 425-525-5392. Providence Medical Group Clinic specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Complete Clinic Profile:
Providence Medical Group Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Mr. Donald W Anderson Jr.
Position:
Assistant Secretary Enrollment
Contact Number:
425-525-5392
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Providence Medical Group clinic are as mentioned below.
NPI Number:
1013192806
Parent Organization:
Providence Health & Services - Oregon
NPI Enumeration Date:
31 Dec, 2007
NPI Last Update On:
13 Jun, 2024
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Providence Medical Group are as mentioned below.
Specialization
License Number
State
Status
Psychiatry
Oregon
Primary
Neurology
Secondary
Child & Adolescent Psychiatry
Oregon
Secondary
Geriatric Psychiatry
Oregon
Secondary
Adult Mental Health
Secondary
Adolescent and Children Mental Health
Secondary
Nurse Practitioner
Secondary
Psych/Mental Health
Oregon
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
245786
Medicaid
Oregon
500601075
Medicaid
Oregon
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Providence Medical Group Po Box 3158, Portland, Oregon
Zip:
97208-3158
Phone Number:
503-215-6494
Fax Number:
503-215-6644
Patients can reach Providence Medical Group at 9155 Sw Barnes Rd, Ste 333, Portland, Oregon or can call to book an appointment on 503-216-5102. *Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.