Organization · Type 2 NPI

Providence Health & Services - Oregon

Interventional Cardiology Physician · Medford, OR

NPI number 1487733929 Active

Practice location

1698 E Mcandrews Rd, Suite 300
Medford, OR 97504-5589

Call (541) 732-7850 Map

Fax (541) 732-7851

Mailing address

PO Box 31001 - 4180
Pasadena, CA 91110-4180

Specialties and licenses

Taxonomy	Code	License
Interventional Cardiology Physician Primary	207RI0011X	None listed
Clinic/Center	261Q00000X	None listed

Interventional Cardiology Physician: An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

35 other providers at this address

NPI record

NPI: 1487733929
Entity type: Organization (Type 2)
Issued: Nov 3, 2006
Last updated: Nov 19, 2025
Status: Active
Subpart: Yes of Providence Health & Services - Oregon

Other names

<unavail>
PMG South Cardiology · doing business as
Providence Medical Group South · doing business as

Authorized official

Donald Wayne Anderson
Assistant Secretary Enrollment
(425) 358-9786

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1487733929

Providence Health & Services - Oregon's National Provider Identifier is 1487733929, issued on Nov 3, 2006. The primary taxonomy on file is Interventional Cardiology Physician (207RI0011X), and the practice location is in Medford, OR. The record was last updated on Nov 19, 2025.