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institution
Providence Health & Services Oregon
Clinic/Center in Medford, Oregon
NPI 1093976243

Providence Health & Services Oregon is a Clinic/Center based in Portland, OR. Providence Health & Services Oregon practices in Medford, OR. The NPI Number for Providence Health & Services Oregon is 1093976243 and holds a License No. (Oregon).

The current practice location address for Providence Health & Services Oregon is 1111 Crater Lake Ave, Medford, OR and can be reached out via phone at 541-732-5250 and via fax at 541-732-5251.

Location: 1111 Crater Lake Ave, Medford, OR, 97208-3308
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1093976243
Provider Name
Providence Health & Services Oregon
Credential
Provider Entity Type
Organization
Address
1111 Crater Lake Ave, Medford, OR, 97208-3308
Phone Number
541-732-5250
Fax Number
541-732-5251
Provider Enumeration Date
06/20/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500617088 05 OR
institution
Provider Business Practice Location Address Details
Address
1111 Crater Lake Ave
City
Medford
State
Oregon
Zip
97504-6241
Phone Number
541-732-5250
Fax Number
541-732-5251
person
Provider Business Mailing Address Details
Address
1111 Crater Lake Ave
City
Medford
State
Oregon
Zip
97504-6241
Phone Number
541-732-5250
Fax Number
541-732-5251
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
(Oregon)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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