OrganizationActive
Providence Health & Services Oregon
NPI 1396818993 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Portland, OR
Provider details
- NPI number
- 1396818993
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Providence Health & Services - Oregon
- Organization subpart
- Yes
- Authorized official
- Donald Anderson, Assistant Secretary Enrollments(425) 358-9786
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
4805 Ne Glisan St
Portland, OR 97213-2933
Phone: (503) 215-4323
Fax: (503) 215-0297
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 3395
Portland, OR 97208-3395
Other names (DBA / former)
- Doing business as
- Providence Portland Medical Center
- Doing business as
- Providence Portland Medical Center
Registry dates
- Enumerated
- 2006-11-15
- Last updated
- 2025-05-07
- Certified
- 2025-05-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.