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Contact Information

PROVIDENCE HEALTH & SERVICES OREGON
5050 NE HOYT ST
SUITE 454
PORTLAND, OR97213
 Phone: 503-215-6405
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Clinic/Center

261Q00000X
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH & SERVICES OREGON

NPI Number 1447371117
LBN Legal business name PROVIDENCE HEALTH & SERVICES OREGON
Authorized official DONALD ANDERSON - (ASSISTANT SECRETARY ENROLLMENT)
Entity Organization
Organization subpart 1 No
Enumeration date 04/02/2007
Last updated 07/04/2025 - About 11 months ago
Identifiers
OR Medicaid 048624
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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