PROVIDENCE HEALTH & SERVICES - OREGON (NPI# 1174969778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174969778 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - OREGON |
| Other Organization Name | PMG ASHLAND |
| Practice Address |
1661 Highway 99 N Building A, Suite 100 Ashland OR 97520-8900 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5417328300 |
| Practice Fax Number | 5417328301 |
| Mailing Telephone | 5417328300 |
| Mailing Fax Number | 5417328301 |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2020-05-01 |
| Authorized Official Name | JOHN W JACKSON (CEO) |
| Authorized Official Telephone | 5417326000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500661228 | 05 |
| Other Name | Type Code |
|---|---|
| PMG Ashland | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922481456 | Providence Health & Services - Oregon | Psychiatry & Neurology | 10830 Highway 62, Eagle Point, OR 97524-9516 | 2015-07-01 |
| 1023440435 | Providence Health & Services - Oregon | General Acute Care Hospital | 11445 Se Moon Dust Ct, Happy Valley, OR 97086-8033 | 2013-08-08 |
| 1568793313 | Providence Health & Services - Oregon | Clinic/Center | 17550 Provost St Ste 201, Lake Oswego, OR 97034-5199 | 2010-01-19 |
| 1508015348 | Providence Health & Services - Oregon | Clinic/Center | 16180 Se Sunnyside Road, Suite 102, Happy Valley, OR 97015-6302 | 2008-09-17 |
| 1114085545 | Providence Health & Services - Oregon | Internal Medicine | 1314 E Sherman St, Newberg, OR 97132-1842 | 2006-12-05 |
| 1629146121 | Providence Health & Services - Oregon | Otolaryngology | 310 Villa Rd, Suite 104, Newberg, OR 97132-1886 | 2006-12-01 |
| 1992882500 | Providence Health & Services - Oregon | Clinic/Center | 205 N Phoenix Rd, Suite A, Phoenix, OR 97535-9104 | 2006-11-01 |
| 1013018175 | Providence Health & Services - Oregon | Clinic/Center | 510 Bridge St, Vernonia, OR 97064-1218 | 2006-09-25 |
| 1447799523 | Providence Health & Services - Oregon | Clinic/Center | 1698 E Mcandrews Rd Ste 170, Medford, OR 97504-5590 | 2017-02-22 |
| 1063963106 | Providence Health & Services - Oregon | Clinic/Center | 1698 E Mcandrews Rd, Ste 300, Medford, OR 97504-5589 | 2016-10-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Oregon | 1801 Lind Avenue, Sw, Renton, WA 98057-9016 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| System for Award Management (SAM) Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 4400 Ne Halsey St Bldg 2 Ste 690, Portland, OR 97213-1545 |
| Iowa Business Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave. Sw, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw # 9016, Renton, WA 98057 |
| Street Address |
1661 HIGHWAY 99 N BUILDING A, SUITE 100 |
| City | ASHLAND |
| State | OR |
| Zip Code | 97520-8900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710091715 | Molly Mccormick Gramley | Internal Medicine | 1661 Highway 99 N, Bldg A, Ste 100, Ashland, OR 97520-8900 | 2006-08-18 |
| 1770913295 | Providence Health & Services - Oregon | Clinic/Center | 1661 Highway 99 N, Building A, Ste 1100, Ashland, OR 97520-8900 | 2013-11-19 |
| 1154687259 | Sara Elizabeth Walz | Internal Medicine | 1661 Highway 99 N, Building A, Ste 100, Ashland, OR 97520-8900 | 2012-04-03 |
| 1336328624 | Justin Theo Johnson | Podiatrist | 1661 Highway 99 N, Ste 201, Ashland, OR 97520-8900 | 2007-11-02 |
| 1689722795 | Karin B Kuhl | Internal Medicine | 1661 Highway 99 N, Bldg A, Ste 100, Ashland, OR 97520-8900 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699390435 | Susan Kathleen Phelps | Massage Therapist | 280 E. Hersey St., Suite B17, Ashland, OR 97520 | 2020-06-08 |
| 1891276101 | William Charles Southworth | Internal Medicine | 866 Blaine St.., Ashland, OR 97520 | 2018-08-24 |
| 1326545625 | Daniel Jordan Decillis | Dentist | 1144 Iowa St Ste A, Ashland, OR 97520 | 2018-04-12 |
| 1730690959 | Eleyah Knight | Acupuncturist | 850 Siskyou Blvd. #6, Ashland, OR 97520 | 2017-10-15 |
| 1881117752 | Elizabeth Kristine Follett | Speech-Language Pathologist | 3265 Biddle Road, Medford, OR 97520 | 2017-07-21 |
| 1457895955 | Graham Collins Inc. | Counselor | 1600 Tolman Creek Rd, Ashland, OR 97520 | 2016-12-19 |
| 1720538010 | Kate Preskenis, Lmt, LLC | Massage Therapist | 823 Siskiyou Blvd., Ashland, OR 97520 | 2016-10-11 |
| 1366899445 | Nadejda Ioana Razi Robertson | Social Worker | 246 Second Street, Ashland, OR 97520 | 2016-05-19 |
| 1225496193 | Teena Summers | Marriage & Family Therapist | 200 Ohio St., Ashland, OR 97520 | 2016-02-05 |
| 1114392016 | Amanda Rose | Doula | 2233 Villard St Apt 203, Ashland, OR 97520 | 2015-12-04 |
| Find all providers in zip 97520 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417042458 | Curators of The University of Missouri | Clinic/Center | 605 Douglas Dr # C, Ashland, MO 65010-9088 | 2006-10-04 |
| 1891327086 | Dependable Healthcare Providers LLC | Clinic/Center | 202 Maple St, Ashland, OH 44805-3212 | 2020-02-06 |
| 1932408218 | Sanjiv Gupta, M.d., P.s.c. | Clinic/Center | 101 Ashland Dr, Ashland, KY 41101-7001 | 2011-03-25 |
| 1942434378 | The Duluth Clinic, Ltd | Clinic/Center | 2101 Beaser Ave, Suite 1, Ashland, WI 54806-3638 | 2009-05-13 |
| 1215974357 | The Duluth Clinic, Ltd | Clinic/Center | 1615 Maple Ln Ste 1, Ashland, WI 54806-3610 | 2006-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972113306 | Harney District Hospital | Clinic/Center | 271 N Egan Ave, Burns, OR 97720-1733 | 2020-07-31 |
| 1922583616 | Wvp Medical Group, LLC | Clinic/Center | 2995 Ryan Dr Se Ste 200, Salem, OR 97301-5157 | 2018-09-27 |
| 1588153076 | Kaiser Foundation Health Plan of The Northwest | Clinic/Center | 3060 Se Hawthorne Blvd, Portland, OR 97214-4121 | 2018-05-09 |
| 1942718457 | Mid-columbia Medical Center | Clinic/Center | 1815 E 19th St Ste 1, The Dalles, OR 97058-3385 | 2018-01-18 |
| 1255844908 | Affordable Health Care & Chiropractic Inc | Clinic/Center | 2130 Se 96th Ave, Portland, OR 97216-2603 | 2017-11-15 |
| 1710402532 | Edge Medical Services Inc | Clinic/Center | 19800 Village Office Ct Ste 15, Bend, OR 97702-1872 | 2017-08-14 |
| 1699167239 | Community Wellness Center | Clinic/Center | 1995 8th Ave, West Linn, OR 97068-4604 | 2015-02-19 |
| 1730518754 | Rebecca Berzow Nd | Clinic/Center | 15455 Nw Greenbrier Pkwy Ste 100, Beaverton, OR 97006-7357 | 2013-11-12 |
| 1659605707 | University Professional Services | Clinic/Center | 2858 Eberlein Ave, Klamath Falls, OR 97603-4402 | 2009-09-22 |
| 1770769424 | Adapt Training | Clinic/Center | 9923 Sw Arctic Dr, Beaverton, OR 97005-4194 | 2008-01-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.