PROVIDENCE HEALTH & SERVICES - OREGON NPI 1063705887

NPI Information

PROVIDENCE HEALTH & SERVICES - OREGON is a multi-specialty clinic center in Medford, OR. PROVIDENCE HEALTH & SERVICES - OREGON NPI is 1063705887. The provider is registered as an organization entity type.
The provider Is Doing Business As Pmg Medford Physiatry.

The provider's business location address is:

920 ROYAL AVE
MEDFORD, OR
ZIP 97504-169
Phone: (541) 732-8400
Fax: (541) 732-8401

The provider's authorized official is Donald W Anderson .
The authorized official title is Dir Reimb Reg Strat/asst Sec Enroll and has the following contact phone number (425) 525-5392.

The CLIA number assigned to this NPI record is 38D2109826 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/26/2011 and was last updated on 10/1/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.