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PROVIDENCE HEALTH & SERVICES - OREGON NPI 1225378615


NPI Information

NPI: 1225378615
Provider Name: PROVIDENCE HEALTH & SERVICES - OREGON

Doing Business As: PROVIDENCE ST VINCENT HEART CLINIC HEART RHYTHM AT NEWBERG

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 38D2173058

Address:
1003 PROVIDENCE DR
SUITE 325
NEWBERG, OR
ZIP 97132
Phone: (503) 216-0770
Get Directions

PROVIDENCE HEALTH & SERVICES - OREGON is a clinic center in Newberg, OR. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PROVIDENCE HEALTH & SERVICES - OREGON NPI is 1225378615. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Providence St Vincent Heart Clinic Heart Rhythm At Newberg.

The provider's business location address is:

1003 PROVIDENCE DR
SUITE 325
NEWBERG, OR
ZIP 97132-521
Phone: (503) 216-0770

The provider's authorized official is Keenan B Freeman .
The authorized official title is Cfo and has the following contact phone number (503) 893-6524.

The CLIA number assigned to this NPI record is 38D2173058 - ancillary testing site in health care center with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 2/21/2013 and was last updated on 4/21/2017.


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
1207RC0000XInternal MedicineCardiovascular DiseaseNo
2207RC0001XInternal MedicineClinical Cardiac ElectrophysiologyNo
3261Q00000XClinic/CenterYes

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
1500655723MEDICAIDOREGON
2R130132MEDICARE PINOREGON

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: 5/5/2024

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