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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

NPI # 1033804091
LBN Legal business name PROVIDENCE HEALTH & SERVICES OREGON
Authorized official DONALD ANDERSON - (ASSISTANT SECRETARY OF ENROLLMENTS)
Entity Organization
Organization subpart 1 No
Enumeration date 04/06/2023
Last updated 06/20/2025 - About 12 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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