OrganizationActive
Providence Health & Services-Oregon
NPI 1376625137 · Nursing Facility/Intermediate Care Facility · Portland, OR
Provider details
- NPI number
- 1376625137
- Entity type
- Organization
- Primary specialty
- Nursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Donald Anderson, Assistant Secretary for Enrollments(425) 358-9786
- License
- 1035453259 (OR)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Nursing & Custodial Care Facilities
Respite Care Facility
Practice location
830 Ne 47th Ave
Portland, OR 97213-2212
Phone: (503) 215-2400
Fax: (503) 215-0660
Approximate (ZIP-level) locationGet directions
Mailing address
830 Ne 47th Ave
Portland, OR 97213-2212
Other names (DBA / former)
- Doing business as
- Providence Child Center
- Doing business as
- Providence Child Center
Registry dates
- Enumerated
- 2006-10-20
- Last updated
- 2025-05-15
- Certified
- 2025-05-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.