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.
Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Other names
PROVIDENCE MEDICAL GROUP, Providence Medical Group Tanasbourne Immediate Care
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON (ASST CORP SECRETARY FOR ENROLLMENTS)
(425) 525-5392
Entity
Organization
Contact information
Practice address
10670 NE CORNELL RD STE 101, HILLSBORO, OR 97124-9221
(503) 216-9360
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
NULL
Other
Enumeration date
09/26/2006
Last updated
03/23/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers