Providence Health & Services Oregon

NPI #1164623401 in Portland, Oregon

Provider Information

NPI Number: 1164623401
Entity Type: Organization
Organization Name: Providence Health & Services Oregon
Primary Specialty: Internal Medicine
Enumeration Date: May 31, 2007
Last Updated: Jun 20, 2025

Practice Location

Address: 4400 NE HALSEY ST
City: Portland
State: Oregon
ZIP Code: 97213-1545
Phone: (503) 893-6524

Authorized Official

Name: DONALD WAYNE ANDERSON JR.
Title: ASSISTANT SECRETARY OF ENROLLMENTS
Phone: (425) 358-9786

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X
Clinic/Center	261Q00000X
Internal Medicine	207R00000X	Primary

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