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Contact Information

PROVIDENCE HEALTH & SERVICES OREGON
4400 NE HALSEY ST, BLDG 2
STE 599
PORTLAND, OR97213-9721
 Phone: 503-215-2110
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Psychiatry

2084P0802X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH SERVICES OREGON · (Female)

NPI Number 1033804091
Status Active
Credentials
Entity Individual
Enumeration date 04/06/2023
Last updated 06/20/2025 - About 12 months ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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