PROVIDENCE HEALTH & SERVICES - OREGON (NPI# 1992031595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992031595 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - OREGON |
| Other Organization Name | PMG SOUTH EAGLE POINT |
| Practice Address |
1332 S Shasta Ave Suite A Eagle Point OR 97524-8623 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5418268160 |
| Practice Fax Number | 5418268197 |
| Mailing Telephone | 5418268160 |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2020-08-12 |
| Authorized Official Name | MR. DONALD W ANDERSON JR. (DIR REIMB REG STRAT/ASST SEC ENROLL) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH & SERVICES - OREGON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500617058 | 05 |
| Other Name | Type Code |
|---|---|
| PMG SOUTH EAGLE POINT | 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 |
1332 S SHASTA AVE SUITE A |
| City | EAGLE POINT |
| State | OR |
| Zip Code | 97524-8623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720184013 | Janice A Lindstrom | Family Medicine | 1332 S Shasta Ave, Suite A, Eagle Point, OR 97524-8623 | 2006-09-15 |
| 1326180688 | Leonard Mark Wilk | Family Medicine | 1332 S Shasta Ave, Suite A, Eagle Point, OR 97524-8623 | 2007-02-13 |
| 1952482317 | Carla P Morey | Physician Assistant | 1332 S Shasta Ave, Suite A, Eagle Point, OR 97524-8623 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497373021 | Jennifer Schmidt | Psychologist | 995 Stonewater Dr., Eagle Point, OR 97524 | 2020-07-09 |
| 1639682834 | Marianne Arasmith | Massage Therapist | 6443 Monte Vista Ct, Eagle Point, OR 97524 | 2017-11-09 |
| 1437566163 | Mandy Dawn Walden | Behavioral Analyst | 360 N. Deanjou Ave, Eagle Point, OR 97524 | 2014-07-15 |
| 1710313200 | Casey Joe Winkler | Behavioral Analyst | 587 Sherman Way, Eagle Point, OR 97524 | 2013-09-17 |
| 1871745901 | Keith Fusao Ogawa | Dentist | 217 W. Main St., Eagle Point, OR 97524 | 2008-10-21 |
| 1578729893 | Tina Louise Matthews | Massage Therapist | 151 West Linn Rd, F6, Eagle Point, OR 97524 | 2008-08-06 |
| 1588700819 | Greg Gonzalez Pediatrics | Clinic/Center | 275 Loto Street, Eagle Point, OR 97524 | 2007-01-30 |
| 1194876235 | Donald Kirk Wolf | Physical Therapist | 158 Main, Eagle Point, OR 97524 | 2007-01-16 |
| 1780759985 | Eagle Point Dental Group,p.c. | Dentist | 217 W Main Street, Eagle Point, OR 97524 | 2006-11-22 |
| 1831268515 | Carmen D Edwards-henry | Speech-Language Pathologist | 1020 Highlands Drive, Eagle Point, OR 97524 | 2006-11-07 |
| Find all providers in zip 97524 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619107695 | Complete Care Chiropractic and Massage | Clinic/Center | 1296 S Shasta Ave, Eagle Point, OR 97524-8521 | 2009-07-23 |
| 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 | ||||
| City | EAGLE POINT |
| Zip Code | 97524 |
Please comment or provide details below to improve the information on PROVIDENCE HEALTH & SERVICES - OREGON.
| 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.