PROVIDENCE HEALTH & SERVICES OREGON (NPI# 1427132265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427132265 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES OREGON |
| Other Organization Name | PROVIDENCE SPECIALTY PHARMACY SERVICES-INFUSION/SPP |
| Practice Address |
6410 Ne Halsey St Suite 400 Portland OR 97213-4742 |
| Mailing Address |
Po Box 5936b Portland OR 97228-5936 |
| Practice Telephone | 5032154652 |
| Mailing Telephone | 5032154652 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2018-12-06 |
| Authorized Official Name | DONALD WAYNE ANDERSON (ASST CORP SECRETARY FOR ENROLLMENTS) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH & SERVICES OREGON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336M0002X |
Pharmacy Specialization: Mail Order Pharmacy |
FM00004097 | WA | Suppliers |
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
RP-0001136-CS | OR | Suppliers |
| Y | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
RP-0001136-CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1044161 | 05 | |
| AK | PH001OR | 05 | |
| UT | 1427132265 | 05 | |
| MT | 1427132265 | 05 | |
| ID | 1427132265 | 05 | |
| OR | 032016 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Specialty Pharmacy Services-Infusion/SPP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518425693 | Providence Health & Services Oregon | Durable Medical Equipment & Medical Supplies | 2296 Nw Kings Blvd Ste 101, Corvallis, OR 97330-3871 | 2019-03-07 |
| 1841756764 | Providence Health & Services Oregon | Family Medicine | 171 N Larch St Ste 16, Cannon Beach, OR 97110-3103 | 2019-02-15 |
| 1346751443 | Providence Health & Services Oregon | General Practice | 4400 Ne Halsey St, Pop 2, 3rd Floor, Portland, OR 97213-1545 | 2017-10-16 |
| 1922453943 | Providence Health & Services Oregon | Assisted Living Facility | 1550 Brookside Dr, Hood River, OR 97031-8553 | 2016-04-27 |
| 1649541020 | Providence Health & Services Oregon | Clinic/Center | 211 Ne Skyline Dr, White Salmon, WA 98672 | 2012-01-18 |
| 1922330828 | Providence Health & Services Oregon | Pharmacy | 18040 Sw Lower Boones Ferry Rd Ste 104, Tigard, OR 97224-7259 | 2010-02-03 |
| 1801010004 | Providence Health & Services Oregon | Internal Medicine | 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 | 2007-04-12 |
| 1487746491 | Providence Health & Services Oregon | Home Health | 2033 Commerce Dr, Medford, OR 97504-9744 | 2006-09-28 |
| 1831196302 | Providence Health & Services Oregon | Home Health | 570 S Main Street, Mount Angel, OR 97362-9540 | 2005-06-30 |
| 1003319724 | Providence Health & Services Oregon | Clinic/Center | 5211 Ne Glisan St Bldg C, Portland, OR 97213-3052 | 2018-03-09 |
| Street Address |
6410 NE HALSEY ST SUITE 400 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213-4742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467431452 | William J Kennedy | Internal Medicine | 6410 Ne Halsey St, Ste 300, Portland, OR 97213-4742 | 2006-01-10 |
| 1417312927 | Rhonda Fisher | Social Worker | 6410 Ne Halsey St, Suite 300, Portland, OR 97213-4742 | 2015-12-28 |
| 1780940171 | Ellen S Ragan | Social Worker | 6410 Ne Halsey St, Suite 300, Portland, OR 97213-4742 | 2012-04-10 |
| 1932479250 | Jennifer C Lawrence | Social Worker | 6410 Ne Halsey St, Ste 300, Portland, OR 97213-4742 | 2012-01-03 |
| 1801180260 | Patricia Fogarty | Internal Medicine | 6410 Ne Halsey St, Suite 300, Portland, OR 97213-4742 | 2011-06-02 |
| 1942516687 | Rachel Ellen Bieber | Registered Nurse | 6410 Ne Halsey St, Portland, OR 97213-4742 | 2010-08-18 |
| 1285945303 | Kathryne M Skinner | Social Worker | 6410 Ne Halsey St, Ste 300, Portland, OR 97213-4742 | 2010-06-23 |
| 1124257746 | Jennifer M Levi | Social Worker | 6410 Ne Halsey St, Suite 300, Portland, OR 97213-4742 | 2009-07-02 |
| 1245470640 | Ruth Ellen Medak | Internal Medicine | 6410 Ne Halsey St, Providence Health & Services, Suite 300, Portland, OR 97213-4742 | 2009-02-24 |
| 1285896464 | Laura Egli Condit | Dietitian, Registered | 6410 Ne Halsey St, 500, Portland, OR 97213-4742 | 2008-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
| 1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
| 1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
| 1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
| 1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
| 1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
| 1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
| Find all providers in zip 97213 | ||||
| Taxonomy Code | 3336H0001X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Home Infusion Therapy Pharmacy |
| Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance. |
| Notes: Source: National Home Infusion Association [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669668752 | Walgreens Specialty Pharmacy LLC | Pharmacy | 9775 Sw Gemini Dr, Ste 1, Beaverton, OR 97008 | 2007-09-21 |
| 1447361514 | Good Samaritan Hospital Corvallis | Pharmacy | 501 Nw Elks Dr Ste 201, Corvallis, OR 97330-3757 | 2006-08-31 |
| 1063458313 | Asante Health Systems, Inc. | Pharmacy | 2900 E. Barnett Rd. Ste. 1, Medford, OR 97504-8380 | 2006-06-22 |
| 1558693291 | Providence Health & Services - Oregon | Pharmacy | 840 Royal Ave, Suite 120, Medford, OR 97504-6461 | 2010-02-05 |
| 1497935985 | Asante | Pharmacy | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2007-11-13 |
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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.