PROVIDENCE HEALTH & SERVICES - OREGON NPI 1013143478

NPI Information

  • NPI: 1013143478
  • Provider Name: PROVIDENCE HEALTH & SERVICES - OREGON
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • :
  • CLIA Number: 38D2203955
  • Address: 16770 SW EDY RD
    SUITE 102
    SHERWOOD, OR
    ZIP 97140
  • Phone: (503) 216-9600

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NPI Details

PROVIDENCE HEALTH & SERVICES - OREGON is an internal medicine in Sherwood, OR. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PROVIDENCE HEALTH & SERVICES - OREGON NPI is 1013143478. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

16770 SW EDY RD
SUITE 102
SHERWOOD, OR
ZIP 97140-679
Phone: (503) 216-9600

The provider's authorized official is Donald W Anderson .
The authorized official title is Assistant Secretary Of Enrollments and has the following contact phone number (425) 358-9786.

The CLIA number assigned to this NPI record is 38D2203955 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/29/2009 and was last updated on 6/20/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterNo
2207R00000XInternal MedicineYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1500611226MEDICAIDOREGON

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: 11/21/2025

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