OrganizationActive
Providence Health & Services - Oregon
NPI 1740732650 · Clinical Pathology Physician · Portland, OR
Provider details
- NPI number
- 1740732650
- Entity type
- Organization
- Primary specialty
- Clinical Pathology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Donald Anderson, Assistant Secretary Enrollments(425) 358-9786
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Anesthesiology Physician207L00000X
Allopathic & Osteopathic Physicians
- Emergency Medicine Physician207P00000X
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
- Body Imaging Physician2085B0100X
Allopathic & Osteopathic Physicians
Practice location
4805 Ne Glisan St
Portland, OR 97213-2933
Phone: (503) 215-1111
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 31001-4199
Pasadena, CA 91110-4199
Other names (DBA / former)
- Doing business as
- Providence Portland Medical Center
Registry dates
- Enumerated
- 2016-10-26
- Last updated
- 2025-05-14
- Certified
- 2025-05-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.