OrganizationActive
Providence Portland Medical Center
NPI 1134240021 · Clinic/Center · Portland, OR
Provider details
- NPI number
- 1134240021
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Providence Portland Medical Center
- Organization subpart
- Yes
- Authorized official
- William Olson, Chief Finance Officer(503) 215-6241
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4805 Ne Glisan St
Suite Bg05
Portland, OR 97213-2933
Phone: (503) 215-2392
Street-level locationGet directions
Mailing address
Po Box 3178
Portland, OR 97208-3178
Other names (DBA / former)
- Doing business as
- Providence Hospitalists East
Registry dates
- Enumerated
- 2007-04-02
- Last updated
- 2007-10-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.