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DSH380038 PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER (Active)
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Main Details
Name
PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH380038
Medicare Provider Number
380038
Additional Details
Current Program Status
Active
Registration Date
4/9/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/20/2015
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Providence Willamette Falls Medical Center
Brad Walker Henry, Chief Executive
(503) 657-6915
Primary Contact
Providence Health and Services
Mac Ovenell, 340B Director
(509) 860-8643
Addresses
Street Address
1500 DIVISION STREET
OREGON CITY, OR 97045
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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