OrganizationActive
Providence Health & Services Oregon
NPI 1356763619 · Diagnostic Radiology Physician · Vancouver, WA
Provider details
- NPI number
- 1356763619
- Entity type
- Organization
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Donald Anderson, Asst Secretary for Enrollments(425) 538-9786
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(81/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
3101 Se 192nd Ave Ste 103
Vancouver, WA 98683-1443
Phone: (360) 666-4480
Fax: (360) 666-4485
Street-level locationGet directions
Mailing address
Po Box 31001 - 4180
Pasadena, CA 91110-4180
Other names (DBA / former)
- Doing business as
- Providence Medical Group
Additional practice locations (1)
- 101 Nw 12th AveSuite 107Battle Ground, WA 98604-9141Phone: (360) 687-6655Fax: (360) 687-6669
Registry dates
- Enumerated
- 2014-01-06
- Last updated
- 2025-07-04
- Certified
- 2025-07-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.