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PROVIDENCE HEALTH & SERVICES - OREGON NPI 1891822995


NPI Information

NPI: 1891822995
Provider Name: PROVIDENCE HEALTH & SERVICES - OREGON
Classification: Case Manager/Care Coordinator - 171M00000X
Entity Type: Organization

CLIA Number: 38D0861845

Address:
2705 E BURNSIDE ST
SUITE 114
PORTLAND, OR
ZIP 97214
Phone: (503) 215-6262
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PROVIDENCE HEALTH & SERVICES - OREGON is a case manager care coordinator in Portland, OR. The provider is a person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. PROVIDENCE HEALTH & SERVICES - OREGON NPI is 1891822995. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2705 E BURNSIDE ST
SUITE 114
PORTLAND, OR
ZIP 97214-763
Phone: (503) 215-6262
Fax: (503) 234-5437

The provider's authorized official is Donald W Anderson .
The authorized official title is Dir Reimb Reg Strat/asst Sec Enroll and has the following contact phone number (425) 525-5392.

The CLIA number assigned to this NPI record is 38D0861845 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/27/2007 and was last updated on 9/21/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1171M00000XCase Manager/Care CoordinatorYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1054002MEDICAIDOREGON
2824986000OTHEROREGONREGENCE CLINIC NUMBER

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.