# PROVIDENCE HEALTH & SERVICES - OREGON

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Medical Group Newberg Specialties at Tanasbourne, PROVIDENCE MEDICAL GROUP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003223959
- **Authorized official:** DONALD WAYNE ANDERSON JR. (ASST SECRETARY FOR ENROLLMENT)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 18650 NW CORNELL RD, SUITE 212, HILLSBORO, OR 97124-9208
- **Practice address phone:** (503) 537-5900
- **Practice address fax:** (503) 537-5959
- **Mailing address:** PO BOX 31001 - 4180, PASADENA, CA 91110-4180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 07/11/2014
- **Last updated:** 06/20/2025