PROVIDENCE HEALTH & SERVICES - OREGON (NPI# 1639279706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639279706 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - OREGON |
| Other Organization Name | PROVIDENCE MEDICAL GROUP TANASBOURNE |
| Practice Address |
18610 Nw Cornell Rd Suite 300 Hillsboro OR 97124-9206 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5032169300 |
| Practice Fax Number | 5032169339 |
| Mailing Telephone | 5032156494 |
| Mailing Fax Number | 5032156644 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-10-02 |
| 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 | 063685 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Medical Group Tanasbourne | 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 |
18610 NW CORNELL RD SUITE 300 |
| City | HILLSBORO |
| State | OR |
| Zip Code | 97124-9206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205835048 | Richard Martin Cade | Family Medicine | 18610 Nw Cornell Rd, Ste 101, Hillsboro, OR 97124-9204 | 2005-07-14 |
| 1760887186 | Lauren Allison Stember | Physician Assistant | 18610 Nw Cornell Rd, Hillsboro, OR 97124 | 2014-10-28 |
| 1417274010 | Christopher Michael Nelson | Family Medicine | 18610 Nw Cornell Rd, Suite 300, Hillsboro, OR 97124-9204 | 2010-04-23 |
| 1306174438 | Providence Health & Services - Oregon | Clinic/Center | 18610 Nw Cornell Rd, Suite 204, Hillsboro, OR 97124-9204 | 2009-12-01 |
| 1801022959 | Andrew P Seaman | Internal Medicine | 18610 Nw Cornell Rd, Ste 101, Hillsboro, OR 97124-9206 | 2009-06-03 |
| 1154555498 | Vanessa Vanderpool | Family Medicine | 18610 Nw Cornell Rd, Suite 101, Hillsboro, OR 97124-9204 | 2009-05-14 |
| 1245481761 | Eric Lee Foote | Physician Assistant | 18610 Nw Cornell Rd, Ste 101, Hillsboro, OR 97124-9206 | 2008-10-02 |
| 1497902274 | Brent L Norris | Physician Assistant | 18610 Nw Cornell Rd, Suite 101, Hillsboro, OR 97124-9204 | 2008-08-22 |
| 1831377175 | Terry Joan Wrobel | Family Medicine | 18610 Nw Cornell Rd, Suite 101, Hillsboro, OR 97124-9206 | 2008-02-08 |
| 1306038427 | Ajay Jagarnath Mohabeer | Preventive Medicine | 18610 Nw Cornell Rd, Suite 204, Hillsboro, OR 97124-9204 | 2007-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538705322 | Pamela Anne Martin | Registered Nurse | 2875 Nw Stucki Pl, Hillsboro, OR 97124 | 2019-11-27 |
| 1912548892 | Donnia Mae Schwarz | Behavior Technician | 5121 Ne Elam Young Pkwy, Hillsboro, OR 97124 | 2019-10-02 |
| 1609305036 | Catherine Lydon | Registered Nurse | 18650 Nw Cornell Road Suite 220, Hillsboro, OR 97124 | 2017-06-08 |
| 1376092163 | Michael Han | Pharmacist | 2875 Nw Stucki Avenue/, Hillsboro, OR 97124 | 2016-09-22 |
| 1760868459 | Voices Set Free | Community/Behavioral Health | 254 North 1st Ave., Hillsboro, OR 97124 | 2015-08-04 |
| 1871980151 | Kevin Kar Fai Cheng | Dentist | 7206 Ne Cornell Rd, Hillsboro, OR 97124 | 2015-04-23 |
| 1336530047 | Maegan Lee Mcglone | Behavioral Analyst | 5801 Ne Cornelius Pass Rd, Hillsboro, OR 97124 | 2015-02-17 |
| 1588095772 | Hillsboro Modern Dentistry, PC | Dentist | 2790 Nw 188th Avenue, Suite A, Hillsboro, OR 97124 | 2013-12-12 |
| 1275977043 | Dana Hazell | Massage Therapist | 5035 Ne Elam Young Parkway, Suite 500, Hillsboro, OR 97124 | 2013-04-24 |
| 1679816771 | Candice May Doyle | Massage Therapist | 5215 Ne Elam Young Park Way, Suite A, Hillsboro, OR 97124 | 2013-03-27 |
| Find all providers in zip 97124 | ||||
| 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 |
|---|---|---|---|---|
| 1104484336 | Laura Rogers LLC | Clinic/Center | 2253 Ne Cornell Rd, Hillsboro, OR 97124-5947 | 2019-06-03 |
| 1003470675 | Symmetry Chiropractic LLC | Clinic/Center | 905 Se Oak St, Hillsboro, OR 97123-4213 | 2019-04-29 |
| 1356714927 | Phoenix Integrative Healthcare, LLC | Clinic/Center | 5300 W Baseline Rd, Hillsboro, OR 97123-6401 | 2015-11-04 |
| 1518214188 | Wilcox Chiropractic Clinic | Clinic/Center | 527 Se Baseline St Ste D, Hillsboro, OR 97123-4149 | 2012-08-13 |
| 1801109988 | Symtrio Chiropractic Clinic, Inc. | Clinic/Center | 6125 Ne Cornell Rd Ste 300, Hillsboro, OR 97124-5417 | 2010-07-19 |
| 1447413661 | Better Days Inc | Clinic/Center | 520 Maple St, Hillsboro, WI 54634-6215 | 2008-07-08 |
| 1972627198 | Westside Medical Clinic | Clinic/Center | 21255 Nw Jacobson Road, Suite 500, Hillsboro, OR 97124-9317 | 2007-03-16 |
| 1245224799 | Jim Riggins | Clinic/Center | 101 Jane Ln, Hillsboro, TX 76645-2673 | 2005-09-09 |
| 1942718622 | Kaiser Foundation Health Plan of The Northwest | Clinic/Center | 19075 Nw Tanasbourne Dr, Hillsboro, OR 97124-5860 | 2018-01-17 |
| 1063969160 | Kaiser Permanente | Clinic/Center | 2875 Nw Stucki Ave, Hillsboro, OR 97124-5806 | 2016-09-07 |
| Find all providers in HILLSBORO | ||||
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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.