| Providence Medical Group | |
|
7305 Se Circuit Dr Hillsboro OR 97123-1915 | |
| (503) 334-4714 | |
| Not Available |
| Full Name | Providence Medical Group |
|---|---|
| Speciality | Clinic/center |
| Location | 7305 Se Circuit Dr, Hillsboro, 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 Medical Group Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Medical Group 7305 Se Circuit Dr Hillsboro OR 97123-1915 Ph: (503) 334-4714 |
| NPI Number | 1124458914 |
|---|---|
| Provider Enumeration Date | 11/15/2013 |
| Last Update Date | 03/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124458914 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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