Providence Medical Group is a Child Neurology Clinic in Portland, Oregon. It is located at 9427 Sw Barnes Rd Ste 395, Portland, OR and its contact number is 503-216-1280. The authorized person for Providence Medical Group is Donald Wayne Anderson Jr.
who is Asst Sec For Enrollment/avp Reimbur of the clinic and his/her contact number is 425-525-5392. Providence Medical Group Clinic specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
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:
Donald Wayne Anderson Jr.
Position:
Asst Sec For Enrollment/avp Reimbur
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:
1316125149
NPI Enumeration Date:
04 Feb, 2008
NPI Last Update On:
22 May, 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
Clinic/center
Primary
Neurology with Special Qualifications in Child Neurology
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
279056
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:
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Fax Number:
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Patients can reach Providence Medical Group at 9427 Sw Barnes Rd Ste 395, Portland, Oregon or can call to book an appointment on 503-216-1280. *Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 January, 2025.