- Clackamas, Multnomah and Washington counties:
Please read enrollment instructions before completing enrollment forms.
Complete the enrollment form and fax it to (503) 574-8653 or mail to:
Providence Medicare Advantage Plans
P.O. Box 5548
Portland, OR 97228-5548
You will receive a notice in the mail acknowledging receipt of your enrollment request.
Individuals must have both Part A and Part B to enroll.