Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Parent organization
PROVIDENCE HEALTH & SERVICES - OREGON
Other names
Providence Portland Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES - OREGON
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 451-3000
(503) 215-0297
Mailing address
PO BOX 31001-4199, PASADENA, CA 91110-4199
(503) 451-3000
(503) 215-0297
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207U00000X
Nuclear Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050000000001
PROVIDENCE HEALTH PLAN
OR
01
—
135983
MEDICAID BHS OUTPT
OR
01
—
138006100
REGENCE HOSPITAL NUMBER
OR
05
—
150300
—
OR
01
—
194075800
US DEPT OF LABOR WC
OR
01
—
3358009
WASHINGTON MEDICAID
OR
01
—
5788
WA DEPT OF LABOR HOSPITAL
OR
01
—
824986000
REGENCE CLINIC NUMBER
OR
01
—
83917
WA DEPT OF LABOR CLINIC
OR
01
—
CP7961
RAILROAD MEDICARE
OR
Enumeration date
10/26/2006
Last updated
05/14/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us