Providence Health & Services - Oregon
NPI 1790107050 · Dermatology Physician · Clackamas, OR
Providence Health & Services - Oregon is a Dermatology Physician organization in Clackamas, OR (NPI 1790107050).
Provider details
- NPI number
- 1790107050
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Donald Anderson, Asst Sec Enrollment(425) 358-9786
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Clinic/Center261Q00000X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 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
Mailing address
Other names (DBA / former)
- Doing business as
- Providence Medical Group
- Doing business as
- Providence Medical Group Glisan Dermatology at Sunnyside
Registry dates
- Enumerated
- 2014-01-06
- Last updated
- 2025-07-01
- Certified
- 2025-07-01
Frequently asked questions
- What is Providence Health & Services - Oregon's NPI number?
- Providence Health & Services - Oregon's National Provider Identifier (NPI) is 1790107050, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Providence Health & Services - Oregon?
- Providence Health & Services - Oregon is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Providence Health & Services - Oregon located?
- Providence Health & Services - Oregon's practice location on file with NPPES is 9290 Se Sunnybrook Blvd, Clackamas, OR 97015-6802.
- What is Providence Health & Services - Oregon's phone number?
- The practice phone number listed in the NPPES registry for Providence Health & Services - Oregon is (503) 215-9080.
- Who is the authorized official for Providence Health & Services - Oregon?
- The authorized official listed on Providence Health & Services - Oregon's NPPES record is Donald Anderson, Asst Sec Enrollment. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Providence Health & Services - Oregon's NPI active?
- Yes — Providence Health & Services - Oregon's NPI (1790107050) is active in the NPPES registry as of the last update on 2025-07-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.