# PROVIDENCE HEALTH & SERVICES - OREGON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PROVIDENCE ST VINCENT MC - CARDIAC TRANSPLANT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629720479
- **Authorized official:** DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 9205 SW BARNES RD, PORTLAND, OR 97225-6603
- **Practice address phone:** (503) 215-1234
- **Mailing address:** PO BOX 31001-4199, PASADENA, CA 91110-4199
- **Mailing address phone:** (503) 215-1234

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204F00000X | Transplant Surgery Physician | — | NULL | Yes |
| 204F00000X | Transplant Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/24/2022
- **Last updated:** 05/07/2025