PROVIDENCE HEALTH & SERVICES - OREGON (NPI# 1013143478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013143478 |
Entity Type | Organization |
Organization Name | PROVIDENCE HEALTH & SERVICES - OREGON |
Other Organization Name | PROVIDENCE MEDICAL GROUP SHERWOOD IMMEDIATE CARE |
Practice Address |
16770 Sw Edy Rd Suite 102 Sherwood OR 97140-9679 |
Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
Practice Telephone | 5032169600 |
Enumeration Date | 2009-05-29 |
Last Update Date | 2020-07-15 |
Authorized Official Name | MR. DONALD W ANDERSON JR. (DIR REIMB REG STRAT/ASST SEC ENROLL) |
Authorized Official Telephone | 4255255392 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 500611226 | 05 |
Other Name | Type Code |
---|---|
Providence Medical Group Sherwood Immediate Care | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922481456 | Providence Health & Services - Oregon | Psychiatry & Neurology | 10830 Highway 62, Eagle Point, OR 97524-9516 | 2015-07-01 |
1023440435 | Providence Health & Services - Oregon | General Acute Care Hospital | 11445 Se Moon Dust Ct, Happy Valley, OR 97086-8033 | 2013-08-08 |
1568793313 | Providence Health & Services - Oregon | Clinic/Center | 17550 Provost St Ste 201, Lake Oswego, OR 97034-5199 | 2010-01-19 |
1508015348 | Providence Health & Services - Oregon | Clinic/Center | 16180 Se Sunnyside Road, Suite 102, Happy Valley, OR 97015-6302 | 2008-09-17 |
1114085545 | Providence Health & Services - Oregon | Internal Medicine | 1314 E Sherman St, Newberg, OR 97132-1842 | 2006-12-05 |
1629146121 | Providence Health & Services - Oregon | Otolaryngology | 310 Villa Rd, Suite 104, Newberg, OR 97132-1886 | 2006-12-01 |
1992882500 | Providence Health & Services - Oregon | Clinic/Center | 205 N Phoenix Rd, Suite A, Phoenix, OR 97535-9104 | 2006-11-01 |
1013018175 | Providence Health & Services - Oregon | Clinic/Center | 510 Bridge St, Vernonia, OR 97064-1218 | 2006-09-25 |
1447799523 | Providence Health & Services - Oregon | Clinic/Center | 1698 E Mcandrews Rd Ste 170, Medford, OR 97504-5590 | 2017-02-22 |
1063963106 | Providence Health & Services - Oregon | Clinic/Center | 1698 E Mcandrews Rd, Ste 300, Medford, OR 97504-5589 | 2016-10-24 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Colorado Business Entities | Providence Health & Services - Oregon | 1801 Lind Avenue, Sw, Renton, WA 98057-9016 |
Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
System for Award Management (SAM) Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 4400 Ne Halsey St Bldg 2 Ste 690, Portland, OR 97213-1545 |
Iowa Business Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave. Sw, Renton, WA 98057 |
Washington State Corporations | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw # 9016, Renton, WA 98057 |
Street Address |
16770 SW EDY RD SUITE 102 |
City | SHERWOOD |
State | OR |
Zip Code | 97140-9679 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942206586 | Mamie D Diaz | Physician Assistant | 16770 Sw Edy Rd, Suite 102, Sherwood, OR 97140-9679 | 2005-06-27 |
1538572458 | Tonya Sartor | Physician Assistant | 16770 Sw Edy Rd, #216, Sherwood, OR 97140-9678 | 2014-06-09 |
1407111693 | Richa Tevatia | Pediatrics | 16770 Sw Edy Rd, Suite 102, Sherwood, OR 97140-9678 | 2012-07-12 |
1184986325 | Anna Meyers | Pediatrics | 16770 Sw Edy Rd, Suite 102, Sherwood, OR 97140-9678 | 2012-06-13 |
1881978724 | David Nathaniel Counts | Physician Assistant | 16770 Sw Edy Rd, Suite 102, Sherwood, OR 97140-9678 | 2011-10-10 |
1760795827 | Megan Rebecca Chaffin | Nurse Practitioner | 16770 Sw Edy Rd, Sherwood, OR 97140-9678 | 2010-07-19 |
1144533480 | Melissa M Sanchez | Nurse Practitioner | 16770 Sw Edy Rd, Ste 102, Sherwood, OR 97140-9678 | 2010-07-15 |
1477794188 | Jaime N Stewart | Physician Assistant | 16770 Sw Edy Rd, Sherwood, OR 97140-9678 | 2009-03-10 |
1285897009 | Alma Sophia Draper | Nurse Practitioner | 16770 Sw Edy Rd, Sherwood, OR 97140-9678 | 2008-07-02 |
1215122833 | Yama A Dehqanzada Dpm PC | Clinic/Center | 16770 Sw Edy Rd, Suite 216, Sherwood, OR 97140-9678 | 2007-09-06 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457902744 | Barbara Jo Morgan | Technician | 17752 Sw Inkster Dr., Sherwood, OR 97140 | 2019-09-27 |
1588193031 | Brett Matthew Hulbert | Student in an Organized Health Care Education/Training Program | 17193 Sw Terrapin Dr. #106, Sherwood, OR 97140 | 2017-06-08 |
1083157416 | Lisa Pauline Knudsen | Counselor | 20512 Sw Roy Rogers Rd, Suite 150, Sherwood, OR 97140 | 2016-12-03 |
1982056479 | Mari Heslinga | Dentist | 21332 Sw Langer Farms Pkwy Ste 126, Sherwood, OR 97140 | 2016-07-07 |
1649634668 | Sheila Johnson | Specialist | 15885 Sw Springtooth Ln, Sherwood, OR 97140 | 2016-04-06 |
1649640335 | Northwest Neurohealth LLC | Clinical Neuropsychologist | 501 N. Villa Road, Newberg, OR 97140 | 2015-10-07 |
1366841785 | Tae Yoon | Pharmacist | 21320 Sw Langer Farms Parkway, Sherwood, OR 97140 | 2014-08-21 |
1396155701 | Wal-mart Stores, Inc | Technician/Technologist | 21320 Sw Langer Farm, Sherwood, OR 97140 | 2014-05-07 |
1588916662 | Stacey Lynn Ritala | Dental Hygienist | 15962 Sw Tualatin-sherwood Rd., Sherwood, OR 97140 | 2012-10-12 |
1518219310 | Peggy Ann Lewelling | Dental Hygienist | 15962 Sw Tualatin-sherwood Rd, Sherwood, OR 97140 | 2012-10-04 |
Find all providers in zip 97140 |
Taxonomy Code | 261Q00000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508488255 | Skinner Family Dentistry | Clinic/Center | 312 E Kiehl Ave, Sherwood, AR 72120-2922 | 2020-05-15 |
1215207378 | Aom Oriental Health | Clinic/Center | 16115 Sw 1st St Ste 202, Sherwood, Or 97140, Sherwood, OR 97140-9259 | 2012-01-06 |
1700045812 | Sherwood Acupuncture, LLC | Clinic/Center | 20508 Sw Roy Rogers Rd, C-115, Sherwood, OR 97140-9932 | 2008-06-03 |
1013045152 | Sherwood Family Eye Health LLC | Clinic/Center | 20407 Sw Borchers Dr, Suite 202, Sherwood, OR 97140-8760 | 2007-03-01 |
1417929811 | North River Surgery Center, LLC | Clinic/Center | 2209 Wildwood Ave, Sherwood, AR 72120-5074 | 2006-02-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932715935 | J.w. Smith, D.c., LLC | Clinic/Center | 4747 S 6th St Ste 2, Klamath Falls, OR 97603-4993 | 2020-09-16 |
1427662204 | Edmund H. Torkelson Do, PC | Clinic/Center | 1960 Nw 167th Pl Ste 204, Beaverton, OR 97006-4804 | 2020-08-31 |
1134746589 | Redmond Veterinary Clinic PC | Clinic/Center | 1785 Nw 6th St, Redmond, OR 97756-1204 | 2020-07-01 |
1801413240 | Gfm LLC | Clinic/Center | 1235 Se Division St Ste 114, Portland, OR 97202-1042 | 2020-07-01 |
1184240277 | Evans & Company Healthcare PC | Clinic/Center | 2330 Morada Ln, Ashland, OR 97520-3641 | 2020-06-24 |
1427674324 | Northwest Pain Institute | Clinic/Center | 2005 Cedar St, Forest Grove, OR 97116-1701 | 2020-06-17 |
1275168759 | Metatron Health LLC | Clinic/Center | 6464 Sw Borland Rd Ste C3, Tualatin, OR 97062-8856 | 2020-03-05 |
1427680057 | Ortc, LLC | Clinic/Center | 750 Biddle Rd Ste 102, Medford, OR 97504-6178 | 2020-02-11 |
1134750037 | Legacy Good Samaritan Hospital and Medical Center | Clinic/Center | 1040 Nw 22nd Ave Ste 250, Portland, OR 97210-3057 | 2020-01-29 |
1861038382 | Clackamas County | Clinic/Center | 2051 Kaen Rd Ste 210, Oregon City, OR 97045-4035 | 2019-11-19 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.