PROVIDENCE HEALTH & SERVICES OREGON NPI 1447371117

NPI Information

  • NPI: 1447371117
  • Provider Name: PROVIDENCE HEALTH & SERVICES OREGON
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • Doing Business As: PROVIDENCE MEDICAL GROUP
  • CLIA Number: 38D0863204
  • Address: 5050 NE HOYT ST
    SUITE 454
    PORTLAND, OR
    ZIP 97213
  • Phone: (503) 215-6405

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NPI Details

PROVIDENCE HEALTH & SERVICES OREGON is an internal medicine in Portland, 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 1447371117. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Providence Medical Group.

The provider's business location address is:

5050 NE HOYT ST
SUITE 454
PORTLAND, OR
ZIP 97213
Phone: (503) 215-6405

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

The CLIA number assigned to this NPI record is 38D0863204 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/2/2007 and was last updated on 6/20/2024.

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
1207Q00000XFamily MedicineNo
2207R00000XInternal MedicineYes
3261Q00000XClinic/CenterNo

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
1048624MEDICAIDOREGON

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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