| One Medical With Providence | |
|
9205 Sw Barnes Rd Mt7878 Portland OR 97225-6603 | |
| (503) 216-4961 | |
| Not Available |
| Full Name | One Medical With Providence |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 9205 Sw Barnes Rd, Portland, Oregon |
| Authorized Official Name and Position | Donald Wayne Anderson (ASST SEC FOR ENROLLMENT/DIR REIMB S) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| One Medical With Providence Po Box 3158 Portland OR 97208-3158 Ph: (503) 215-6494 | One Medical With Providence 9205 Sw Barnes Rd Mt7878 Portland OR 97225-6603 Ph: (503) 216-4961 |
| NPI Number | 1053403394 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 04/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053403394 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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