| Providence Hospitalists West | |
|
9205 Sw Barnes Rd 5th Floor South Portland OR 97225-6603 | |
| (503) 216-2906 | |
| Not Available |
| Full Name | Providence Hospitalists West |
|---|---|
| Speciality | Clinic/center |
| Location | 9205 Sw Barnes Rd, Portland, Oregon |
| Authorized Official Name and Position | Dennis Noonan (CHIEF FIANCE OFFICER) |
| Authorized Official Contact | 5032164657 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Hospitalists West Po Box 3178 Portland OR 97208-3178 Ph: () - | Providence Hospitalists West 9205 Sw Barnes Rd 5th Floor South Portland OR 97225-6603 Ph: (503) 216-2906 |
| NPI Number | 1770604670 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 10/30/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770604670 | NPI | - | NPPES |
| 286604 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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