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Providence Health & Services - Oregon

Child & Adolescent Psychiatry Physician in Medford, OR · enumerated 2006 · authorized official Donald Anderson, Assistant Secretary Enrollment.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1316024128

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Registry record

Entity type Organization (Type 2)
Legal business name Providence Health & Services - Oregon
Other name <Unavail>
Parent organization Providence Health & Services - Oregon
Practice address 840 Royal Ave, Suite 110, Medford, OR, 97504
Fax (541) 732-8371
Enumeration date Nov 1, 2006
Last updated in NPPES Nov 19, 2025

Taxonomy & classification

2084P0804X Child & Adolescent Psychiatry Physician Allopathic & Osteopathic Physicians Primary
261Q00000X Clinic/Center Ambulatory Health Care Facilities Secondary
261QM0855X Adolescent and Children Mental Health Clinic/Center Ambulatory Health Care Facilities Secondary

Authorized official

Name Donald Anderson
Title Assistant Secretary Enrollment

Other identifiers

Identifier Type State Issuer
CG6801 Other OR RAIL ROAD MEDICARE

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Providence Health & Services - Oregon located?
The practice location on file with NPPES is in Medford, OR.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2025-11-19. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-11-19.