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Providence Health & Services - Oregon
Adolescent and Children Mental Health Clinic/Center in Medford, Oregon
NPI 1316024128

Providence Health & Services - Oregon is an Adolescent and Children Mental Health Clinic/Center based in Portland, OR and is specialized in Adolescent and Children Mental Health. Providence Health & Services - Oregon practices in Medford, OR. The NPI Number for Providence Health & Services - Oregon is 1316024128 and holds a License No. (Oregon).

The current practice location address for Providence Health & Services - Oregon is 840 Royal Ave, Medford, OR and can be reached out via phone at 541-732-8370 and via fax at 541-732-8371. You can also correspond with Providence Health & Services - Oregon through the mailing address at PO BOX 3158, PORTLAND, OR - 97208-3158 (mailing address contact number: 503-215-6494).

Location: 840 Royal Ave, Medford, OR, 97208-3158
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1316024128
Provider Name
Providence Health & Services - Oregon
Credential
Provider Entity Type
Organization
Address
840 Royal Ave, Medford, OR, 97208-3158
Phone Number
541-732-8370
Fax Number
541-732-8371
Provider Enumeration Date
11/01/2006
Last Update Date
03/12/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
CG6801 01 OR RAIL ROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
840 Royal Ave
City
Medford
State
Oregon
Zip
97504-6461
Phone Number
541-732-8370
Fax Number
541-732-8371
person
Provider Business Mailing Address Details
Address
Po Box 3158
City
Portland
State
Oregon
Zip
97208-3158
Phone Number
503-215-6494
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Child & Adolescent Psychiatry
Taxonomy
2084P0804X
License No.
()
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
()
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).
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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