PROVIDENCE HEALTH & SERVICES - OREGON (NPI# 1194996991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194996991 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - OREGON |
| Other Organization Name | PROVIDENCE PEDIATRIC NEUROLOGY BEND |
| Practice Address |
2200 Ne Professional Ct Bend OR 97701-6063 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5413896313 |
| Mailing Telephone | 5032156494 |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2013-09-25 |
| Authorized Official Name | KEENAN B FREEMAN (CFO) |
| Authorized Official Telephone | 5038936524 |
| 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 | 279130 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Pediatric Neurology Bend | 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 |
2200 NE PROFESSIONAL CT |
| City | BEND |
| State | OR |
| Zip Code | 97701-6063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992793988 | Jennifer G. Lachman | Pediatrics | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2005-10-12 |
| 1740889781 | Georgia Elizabeth Brown | Dietitian, Registered | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2020-10-21 |
| 1417554718 | Elizabeth Paige | Social Worker | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2020-10-08 |
| 1043825490 | Shelanna Rae Burton | Community Health Worker | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2020-09-12 |
| 1306228200 | Molly Radis | Nurse Practitioner | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2015-06-26 |
| 1942695028 | Dana Elizabeth Honzel Angelos | Pediatrics | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2015-04-05 |
| 1871936880 | Kristopher Cox | Physician Assistant | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2013-04-09 |
| 1609158161 | Hailey Marie Garside | Nurse Practitioner | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2011-09-12 |
| 1295050680 | Leslie Austin Rust | Pediatrics | 2200 Ne Professional Ct, Bend, OR 97701 | 2010-03-29 |
| 1144552936 | Trisha D Stephens | Dietitian, Registered | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2010-02-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104465525 | Andrew Kyle Burzynski | Denturist | 853 Ne 4th St., Bend, OR 97701 | 2020-01-02 |
| 1013480714 | Andrew Traut | Specialist/Technologist | Oregon State Force Lab, 2200 Ne Neff Rd Suite 202, Bend, OR 97701 | 2019-01-04 |
| 1871063917 | Calley Asbill, Nd LLC | Chiropractor | 2146 Ne 4th Street, Suite 160, Bend, OR 97701 | 2018-12-02 |
| 1902372212 | Carisa S Battin | Counselor | 361 Ne Franklin Avenue Bldg E #4, Bend, OR 97701 | 2018-10-15 |
| 1366921223 | Hillside Eye Center LLC | Ophthalmology | 625 Nw Colorado Avenue, Bend, OR 97701 | 2018-08-11 |
| 1528545514 | Kellie Michiko Kawasaki-jones | Dentist | 62968 Ob Riley Road, Suite 12, Bend, OR 97701 | 2018-07-23 |
| 1992255327 | Shelby Chiropractic | Chiropractor | 561 Ne Bellevue Dr Ste 102, Bend, OR 97701 | 2016-10-10 |
| 1144671520 | Kevin Richard Pett | Acupuncturist | 39 Nw Louisanna Ave., Hawthorn Healing Arts Center, Bend, OR 97701 | 2016-06-27 |
| 1912357500 | Sheldon Shawn Doveri | Driver | 233 Nw Revere Ave, Bend, OR 97701 | 2016-06-15 |
| 1740647411 | Anne Power | Homeopath | 2100 Ne Neff Rd Suite B, Bend, OR 97701 | 2016-01-26 |
| Find all providers in zip 97701 | ||||
| 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 |
|---|---|---|---|---|
| 1811408537 | Erika Beard-irvine, Md, LLC | Clinic/Center | 403 Ne Revere Avenue, Bend, OR 97701-4018 | 2017-10-20 |
| 1982089207 | Dr. Jeff Mcnown Chiropractic, P.C. | Clinic/Center | 141 Nw Greenwood Ave Ste 101, Bend, OR 97701-2041 | 2015-07-28 |
| 1306262795 | Cascade Cancer Care LLC | Clinic/Center | 25 Nw Louisiana Ave Ste 100, Bend, OR 97701-3294 | 2014-03-11 |
| 1285964304 | Virtual Nurse Practitioner LLC | Clinic/Center | 2654 Ne Jill Ct, Bend, OR 97701-5887 | 2010-01-12 |
| 1073756615 | Adam Derr, P.C. | Clinic/Center | 528 Ne Greenwood Ave, Bend, OR 97701-4611 | 2009-04-13 |
| 1942852165 | Bend Natural Health | Clinic/Center | 2955 N Highway 97, Bend, OR 97703-7559 | 2019-07-09 |
| 1659835106 | Ideal Option, Pllc | Clinic/Center | 404 Ne Penn Ave, Bend, OR 97701-4264 | 2019-01-29 |
| 1356848352 | Omhc, LLC | Clinic/Center | 595 Sw Bluff Dr Ste A, Bend, OR 97702-1283 | 2018-04-07 |
| 1265940308 | Monarch Medical Group LLC | Clinic/Center | 595 Sw Bluff Dr Ste A, Bend, OR 97702-1283 | 2018-01-10 |
| 1952811408 | Plasker Chiropractic and Functional Neurology LLC | Clinic/Center | 155 Sw Century Dr Ste 104, Bend, OR 97702-1657 | 2017-10-10 |
| Find all providers in BEND | ||||
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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.