Organization Name: | PROVIDENCE HEALTH & SERVICES - OREGON |
NPI Number: | 1073686689 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KATHLEEN DOWLING (SYS DIR RC BUSINESS OPERATIONS) |
Mailing Address: | 810 12th St Hood River |
State: | OR US |
Postal Code: | 970311587 |
Phone Number: | 5032154323 |
Fax Number: | 5032150297 |
NPI Enumeration Date: | 11/15/2006 |
NPI Last Update Date: | 01/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |