PROVIDENCE HEALTH & SERVICES OREGON NPI 1396818993

NPI Information

  • NPI: 1396818993
  • Provider Name: PROVIDENCE HEALTH & SERVICES OREGON
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • :
  • Address: 4805 NE GLISAN ST
    PORTLAND, OR
    ZIP 97213
  • Phone: (503) 215-4323

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NPI Details

PROVIDENCE HEALTH & SERVICES OREGON is an end-stage renal disease (esrd) treatment clinic center in Portland, OR. PROVIDENCE HEALTH & SERVICES OREGON NPI is 1396818993. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

4805 NE GLISAN ST
PORTLAND, OR
ZIP 97213-933
Phone: (503) 215-4323
Fax: (503) 215-0297

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

The enumeration date for this NPI number is 11/15/2006 and was last updated on 5/7/2025.

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
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

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: 3/30/2025

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