Providence Medical Group - Primary Care in Gresham, OR

Providence Medical Group is a primary clinic (Clinic/center) in Gresham, Oregon. The current practice location for Providence Medical Group is 440 Nw Division St, Gresham, Oregon. For appointments, you can reach them via phone at (503) 215-9500. The mailing address for Providence Medical Group is Po Box 3158, Portland, Oregon and phone number is (503) 215-6494.

Providence Medical Group is licensed to practice in * (Not Available) (license number ) and its NPI number is 1053419218. This medical practice does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at (503) 215-9500.

Contact Information

Providence Medical Group
440 Nw Division St
Gresham
OR 97030-5506
(503) 215-9500
(503) 215-9525

Primary Care Clinic Profile

Full NameProvidence Medical Group
SpecialityClinic/center
Location440 Nw Division St, Gresham, Oregon
Authorized Official Name and PositionDonald W Anderson (DIR REIMB REG STRAT/ASST SEC ENROLL)
Authorized Official Contact4255255392
Accepts Medicare InsuranceThis clinic does not participate in Medicare Program.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Providence Medical Group
Po Box 3158
Portland
OR 97208-3158

Ph: (503) 215-6494
Providence Medical Group
440 Nw Division St
Gresham
OR 97030-5506

Ph: (503) 215-9500

NPI Details:

NPI Number1053419218
Provider Enumeration Date09/20/2006
Last Update Date08/31/2023

Medical Identifiers

Medical identifiers for Providence Medical Group such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053419218NPI-NPPES
287333MedicaidOR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207RE0101XInternal Medicine - Endocrinology, Diabetes & Metabolism (* (Not Available))Secondary
261Q00000XClinic/center (* (Not Available))Primary

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