Active NPI
Providence Health & Services-Oregon
- Community Based Hospice Care Agency
- Mount Angel, OR
National Provider Identifier
1962844241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- PROVIDENCE HEALTH & SERVICES-OREGON
- Practice address
- 580 S Main St
Mount Angel, OR 97362-9540 - Phone
- (503) 845-2463
- Fax
- (503) 845-2716
- NPI assigned
- Jul 26, 2013
- Organization subpart
- Yes
- Parent organization
- PROVIDENCE HEALTH & SERVICES-OREGON
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Donald W Anderson Jr.
- Title
- Dir Reimb Reg Strat/Asst Sec Enroll
- Phone
- (425) 525-5392
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
580 S Main St
Mount Angel, OR 97362-9540
Mailing address
PO Box 2724
Portland, OR 97208-2724
Phone (503) 215-4601
Other names 1
- Providence Benedictine Hospice
National Provider Directory
National Provider Directory- Part of
- Providence Portland Medical Center
Locations
2520 Pringle Rd SE
Salem, OR 97302
Phone (503) 845-9226
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374796800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1606176000000",
"number": "1962844241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2724",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972082724",
"telephone_number": "503-215-4601",
"fax_number": "503-215-4624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "580 S MAIN ST",
"city": "MOUNT ANGEL",
"state": "OR",
"postal_code": "973629540",
"telephone_number": "503-845-2463",
"fax_number": "503-845-2716"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROVIDENCE HEALTH & SERVICES-OREGON",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PROVIDENCE HEALTH & SERVICES-OREGON",
"enumeration_date": "2013-07-26",
"last_updated": "2020-11-24",
"certification_date": "2020-11-24",
"status": "A",
"authorized_official_last_name": "ANDERSON",
"authorized_official_first_name": "DONALD",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "DIR REIMB REG STRAT/ASST SEC ENROLL",
"authorized_official_telephone_number": "425-525-5392",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Providence Benedictine Hospice",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Providence Benedictine Hospice",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mount Angel, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.