PROVIDENCE HEALTH & SERVICES - OREGON


Address: 16770 Sw Edy Rd, Suite 102, Sherwood, OR 97140-9679
Phone: 5032169600

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261Q00000X Clinic/Center Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
OR 500611226 05

Other Provider/Organization Names

Other Name Type Code
Providence Medical Group Sherwood Immediate Care Doing Business As Name - Organization

Other Provider IDs and Locations

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

Other Data Sources

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

Office Location

Street Address 16770 SW EDY RD
SUITE 102
City SHERWOOD
State OR
Zip Code 97140-9679

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

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).

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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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Competitor

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City SHERWOOD
Zip Code 97140

Improve Information

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Dataset Information

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.

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