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PROVIDENCE HEALTH & SERVICES OREGON NPI 1356763619


NPI Information

NPI: 1356763619
Provider Name: PROVIDENCE HEALTH & SERVICES OREGON

Doing Business As: PROVIDENCE MEDICAL GROUP

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
3101 SE 192ND AVE STE 103
VANCOUVER, WA
ZIP 98683
Phone: (360) 666-4480
Get Directions

PROVIDENCE HEALTH & SERVICES OREGON is a diagnostic radiology radiology in Vancouver, WA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. PROVIDENCE HEALTH & SERVICES OREGON NPI is 1356763619. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Providence Medical Group.

The provider's business location address is:

3101 SE 192ND AVE STE 103
VANCOUVER, WA
ZIP 98683-443
Phone: (360) 666-4480
Fax: (360) 666-4485

The provider's authorized official is Donald Wayne Anderson .
The authorized official title is Asst Secretary For Enrollments and has the following contact phone number (425) 525-5392.

The enumeration date for this NPI number is 1/6/2014 and was last updated on 2/14/2024.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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.