Providence Health & Services - Oregon
Specialty details in registry · Medford, OR
At a glance
1111 Crater Lake Ave, Medford, OR 97504-6241
NPPES record updated Nov 19, 2025. Public records can lag behind changes at a practice.
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- Are you accepting new patients?
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Insurance participation and appointment availability are not established by these public records.
Practice location
1111 Crater Lake AveMedford, OR 97504-6241
Professional details: NPI, taxonomy & registry record
Registry details
- Primary taxonomy
- Specialty details in registry
- Taxonomy code
- 208M00000X
- Enumeration date
- Nov 7, 2012
- Record updated
- Nov 19, 2025
More registry details
- Provider type
- Organization · Type 2
- Other reported name
- <UNAVAIL>
Reported taxonomies and licenses
Specialty details in registry
208M00000X · Primary
License numbers and credentials are reported to NPPES; HCPList does not independently verify them.
Practice location
1111 Crater Lake AveMedford, OR 97504-6241
- Phone
- (541) 732-5545
- Fax
- (541) 732-5548
Mailing address
PO BOX 31001 - 4180PASADENA, CA 911104180
Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.
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