PROVIDENCE HEALTH & SERVICES OREGON NPI 1821224957

NPI Information

  • NPI: 1821224957
  • Provider Name: PROVIDENCE HEALTH & SERVICES OREGON
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • :
  • CLIA Number: 38D2060545
  • Address: 18040 SW LOWER BOONES FERRY RD
    SUITE 100
    TIGARD, OR
    ZIP 97224
  • Phone: (503) 216-0700

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NPI Details

PROVIDENCE HEALTH & SERVICES OREGON is an internal medicine in Tigard, 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 1821224957. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

18040 SW LOWER BOONES FERRY RD
SUITE 100
TIGARD, OR
ZIP 97224
Phone: (503) 216-0700

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

The CLIA number assigned to this NPI record is 38D2060545 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/3/2009 and was last updated on 7/4/2025.

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
1500611230MEDICAIDOREGON

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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