OrganizationActive
Providence Health & Services - Oregon
NPI 1568793313 · Family Medicine Physician · Lake Oswego, OR
Provider details
- NPI number
- 1568793313
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Donald Anderson, Assistant Secretary Enrollment(425) 358-9786
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Clinic/Center261Q00000X
Ambulatory Health Care Facilities
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 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
17550 Provost St Ste 201
Lake Oswego, OR 97034-5199
Phone: (503) 513-3350
Fax: (503) 513-3355
Street-level locationGet directions
Mailing address
Po Box 31001 - 4180
Pasadena, CA 91110-4180
Other names (DBA / former)
- Doing business as
- Providence Medical Group
- Doing business as
- Providence Medical Group West Linn
- Doing business as
- Providence Medical Group West Linn
- Doing business as
- Providence Medical Group at Marys Woods
Registry dates
- Enumerated
- 2010-01-19
- Last updated
- 2026-03-23
- Certified
- 2026-03-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.