| Providence Southeast Oncology & Hematology Clinic | |
|
9280 Se Sunnybrook Blvd Suite 200 Clackamas OR 97015-6776 | |
| (503) 513-1900 | |
| Not Available |
| Full Name | Providence Southeast Oncology & Hematology Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 9280 Se Sunnybrook Blvd, Clackamas, 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 |
|---|---|
| Providence Southeast Oncology & Hematology Clinic Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Southeast Oncology & Hematology Clinic 9280 Se Sunnybrook Blvd Suite 200 Clackamas OR 97015-6776 Ph: (503) 513-1900 |
| NPI Number | 1689836108 |
|---|---|
| Provider Enumeration Date | 06/26/2008 |
| Last Update Date | 04/16/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689836108 | NPI | - | NPPES |
| 242397 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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