OrganizationActive
Providence Health & Services Oregon
NPI 1922330828 · Community/Retail Pharmacy · Tigard, OR
Provider details
- NPI number
- 1922330828
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Donald Anderson, Assistant Secreatry for Enrollment(425) 358-9786
- License
- RP-0002571-CS (OR)
Specialties & taxonomies
Suppliers
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
18040 Sw Lower Boones Ferry Rd Ste 104
Tigard, OR 97224-7259
Phone: (503) 216-0625
Fax: (503) 216-0630
Street-level locationGet directions
Mailing address
18040 Sw Lower Boones Ferry Rd
Tigard, OR 97224-7258
Other names (DBA / former)
- Doing business as
- Providence Bridgeport Pharmacy
Registry dates
- Enumerated
- 2010-02-03
- Last updated
- 2025-07-08
- Certified
- 2025-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.