| Providence Heart Clinic Willamette Falls | |
|
1510 Division St Suite 100 Oregon City OR 97045-1572 | |
| (503) 742-6770 | |
| (503) 742-6777 |
| Full Name | Providence Heart Clinic Willamette Falls |
|---|---|
| Speciality | Clinic/center |
| Location | 1510 Division St, Oregon City, Oregon |
| Authorized Official Name and Position | Donald W Anderson (DIR REIMB REG STRAT/ASST SEC ENROLL) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Heart Clinic Willamette Falls Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Heart Clinic Willamette Falls 1510 Division St Suite 100 Oregon City OR 97045-1572 Ph: (503) 742-6770 |
| NPI Number | 1346533585 |
|---|---|
| Provider Enumeration Date | 05/20/2011 |
| Last Update Date | 09/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346533585 | NPI | - | NPPES |
| 500639265 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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