Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Providence Health & Services - Oregon

Organization Anesthesiology Physician · NPI 1689755670

Providence Health & Services - Oregon is an Anesthesiology Physician in Medford, Oregon. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
7
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Practice location Address checks out

1111 Crater Lake Ave
Medford, OR 97504-6241
Phone: (503) 451-3000
Fax: (503) 215-0290
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Acute Care Hospital (primary) Taxonomy 282N00000X
Anesthesiology Physician Taxonomy 207L00000X
Emergency Medicine Physician Taxonomy 207P00000X
Internal Medicine Physician Taxonomy 207R00000X
Nuclear Medicine Physician Taxonomy 207U00000X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Anatomic Pathology & Clinical Pathology Physician Taxonomy 207ZP0102X

Record details

NPI number1689755670
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Health & Services - Oregon
Authorized official Donald Anderson — Assistant Secretary Enrollments · (425) 358-9786
Other names Providence Medford Medical Center; Providence Medford Medical Center
NPI enumeratedOctober 18, 2006
Last updated in NPPESMay 27, 2025
Certification dateMay 27, 2025
Mailing addressPo Box 31001-4199, Pasadena, CA 91110-4199

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