| Providence Medical Group | |
|
4004 Kruse Way Pl Ste 300 Lake Oswego OR 97035-2479 | |
| (503) 216-1500 | |
| Not Available |
| Full Name | Providence Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 4004 Kruse Way Pl Ste 300, Lake Oswego, Oregon |
| Authorized Official Name and Position | Donald W Anderson (ASST SEC ENROLLMENT/EVP REIMBURSEME) |
| 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: (503) 215-6494 | Providence Medical Group 4004 Kruse Way Pl Ste 300 Lake Oswego OR 97035-2479 Ph: (503) 216-1500 |
| NPI Number | 1205937273 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 06/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205937273 | NPI | - | NPPES |
| 241291 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
Kristina E Harp M.d P.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17704 Jean Way, Suite 105, Lake Oswego, OR 97035 Phone: 503-675-6776 Fax: 503-675-2572 | |
Providence Health & Services Oregon Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4823 Meadows Rd, Lake Oswego, OR 97035 Phone: 503-216-1580 | |
Kimberly J. Schleef D.o., Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3701 Carman Dr, Lake Oswego, OR 97035 Phone: 503-635-6555 Fax: 503-635-6557 | |
Dr Pepel Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15880 Quarry Rd, Lake Oswego, OR 97035 Phone: 503-232-3302 Fax: 503-200-2895 | |
Deni R Buss Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14511 Westlake Dr, Suite 100, Lake Oswego, OR 97035 Phone: 503-449-6939 Fax: 503-598-3980 | |
Lake Oswego Family Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4035 Mercantile Dr, Suite 104, Lake Oswego, OR 97035 Phone: 503-635-1350 Fax: 503-635-8470 | |
Kleiman Healthcare Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 415 N State St Ste 136, Lake Oswego, OR 97034 Phone: 310-951-3450 |