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PROVIDENCE HEALTH & SERVICES OREGON NPI 1801010004


NPI Information

NPI: 1801010004
Provider Name: PROVIDENCE HEALTH & SERVICES OREGON

Doing Business As: PROVIDENCE LIVER CANCER CLINIC

Classification: Internal Medicine - 207RX0202X
Entity Type: Organization

Specialization: Medical Oncology

Address:
4805 NE GLISAN ST STE 11N
PORTLAND, OR
ZIP 97213
Phone: (503) 215-8650
Get Directions

PROVIDENCE HEALTH & SERVICES OREGON is a medical oncology internal medicine in Portland, OR. The provider is an internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. PROVIDENCE HEALTH & SERVICES OREGON NPI is 1801010004. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Providence Liver Cancer Clinic.

The provider's business location address is:

4805 NE GLISAN ST STE 11N
PORTLAND, OR
ZIP 97213-933
Phone: (503) 215-8650
Fax: (503) 215-8653

The provider's authorized official is Donald Wayne Anderson .
The authorized official title is Asst Corp Secretary For Enrollments and has the following contact phone number (425) 525-5392.

The enumeration date for this NPI number is 4/12/2007 and was last updated on 7/19/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0003XInternal MedicineHematology & OncologyNo
2207RI0008XInternal MedicineHepatologyNo
3208600000XSurgeryNo
42086X0206XSurgerySurgical OncologyNo
5261Q00000XClinic/CenterNo
6207RX0202XInternal MedicineMedical OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1274461MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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