OrganizationActive
Providence Health & Services Oregon
NPI 1710152798 · Prosthetic/Orthotic Supplier · Portland, OR
Provider details
- NPI number
- 1710152798
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Parent organization
- Providence Health & Services Oregon
- Organization subpart
- Yes
- Authorized official
- Donald Anderson, Assistant Secretary Enrollment(425) 358-9786
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
Cancer Center 1st Floor
Portland, OR 97213-2933
Phone: (503) 215-8998
Fax: (503) 215-3201
Street-level locationGet directions
Mailing address
Po Box 5936 a
Portland, OR 97228-5936
Other names (DBA / former)
- Doing business as
- Providence Transitions-The Mary Clark Appearance Center
- Doing business as
- Providence Transitions-The Mary Clark Appearance Center
Registry dates
- Enumerated
- 2008-04-29
- Last updated
- 2025-05-16
- Certified
- 2025-05-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.