PROVIDENCE HEALTH & SERVICES - OREGON (NPI# 1730411034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730411034 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - OREGON |
| Other Organization Name | PROVIDENCE SURGERY CLINIC SOUTHEAST |
| Practice Address |
1510 Division St Suite 210 Oregon City OR 97045-1599 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5037236525 |
| Practice Fax Number | 5037236508 |
| Mailing Telephone | 5032156494 |
| Mailing Fax Number | 5032156644 |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2020-08-05 |
| 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 | 500620076 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Medical Group Oregon City General Vascular & Thoracic Surg | Doing Business As Name - Organization |
| Providence Surgery Clinic Southeast | 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 |
1510 DIVISION ST SUITE 210 |
| City | OREGON CITY |
| State | OR |
| Zip Code | 97045-1599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750387049 | Kevin Raymond Johnson I | Surgery | 1510 Division St, Ste 210, Oregon City, OR 97045-1599 | 2005-06-22 |
| 1558819235 | Heather Mirenda | Social Worker | 1510 Division St, 90, Oregon City, OR 97045-1581 | 2016-09-12 |
| 1538454665 | Providence Health & Services - Oregon | Internal Medicine | 1510 Division St, Suite 130, Oregon City, OR 97045-1572 | 2011-06-16 |
| 1346533585 | Providence Health & Services - Oregon | Clinic/Center | 1510 Division St, Suite 100, Oregon City, OR 97045-1572 | 2011-05-20 |
| 1144529306 | Jennifer Eileen Shepard | Pediatrics | 1510 Division St, Suite 280, Oregon City, OR 97045-1581 | 2011-03-26 |
| 1194057497 | Providence Health & Services - Oregon | Clinic/Center | 1510 Division St, Ste 170, Oregon City, OR 97045-1581 | 2010-02-11 |
| 1821320128 | Providence Health & Services - Oregon | Clinic/Center | 1510 Division St, Ste 170, Oregon City, OR 97045-2551 | 2010-02-11 |
| 1891026647 | Providence Health & Services - Oregon | Clinic/Center | 1510 Division St, Suite 200, Oregon City, OR 97045-1599 | 2010-01-19 |
| 1942454087 | Willamette Falls Hospital | Physical Medicine & Rehabilitation | 1510 Division St, Suite 170, Oregon City, OR 97045-1581 | 2008-11-14 |
| 1962665232 | Willamette Falls Hospital | Surgery | 1510 Division St, Ste 210, Oregon City, OR 97045-1581 | 2008-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528625621 | Dylan Wile | Physical Therapist | 19721 Or 213, Oregon City, OR 97045 | 2019-05-23 |
| 1952871576 | April Saylor | Dental Hygienist | 15530 S. Morel Dr, Oregon City, OR 97045 | 2018-11-27 |
| 1598251688 | Sara Noelle Wetten | Dental Assistant | 1900 Mclouglin Blvd #68, Oregon City, OR 97045 | 2018-07-02 |
| 1649761941 | Carol Ann Cranfill | Specialist | 1001 Molalla Ave. Ste 206, Oregon City, OR 97045 | 2018-05-22 |
| 1790286029 | Kathleen Walker | Registered Nurse | 110 Beaverceek Rd., Oregon City, OR 97045 | 2018-02-22 |
| 1174032429 | Amanda Brannin | Dental Hygienist | 15018 Pebble Beach Dr, Oregon City, OR 97045 | 2017-09-28 |
| 1003332669 | Clackamas Medical Supplies | Durable Medical Equipment & Medical Supplies | 2050 Beavercreek Rd. Ste 101-385, Oregon, OR 97045 | 2017-08-16 |
| 1154870129 | Staci S Meador | Nurse Practitioner | 1508 Division St Ste 200, Oregon City, OR 97045 | 2016-10-01 |
| 1821541939 | Samuel R. Sabo | General Practice | 18171 Waldow Rd., Oregon City, OR 97045 | 2016-07-26 |
| 1619339967 | Carly Chambers | Physical Therapist | 1630 S Beavercreeak Rd, Suite A, Oregon City, OR 97045 | 2016-03-25 |
| Find all providers in zip 97045 | ||||
| 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 |
|---|---|---|---|---|
| 1861038382 | Clackamas County | Clinic/Center | 2051 Kaen Rd Ste 210, Oregon City, OR 97045-4035 | 2019-11-19 |
| 1679070437 | Mallory & White PC | Clinic/Center | 619 Madison St Ste 108, Oregon City, OR 97045-2354 | 2018-04-09 |
| 1700259843 | Pokelndia LLC | Clinic/Center | 1300 John Adams St, Ste 119, Oregon City, OR 97045-1695 | 2015-11-12 |
| 1346533585 | Providence Health & Services - Oregon | Clinic/Center | 1510 Division St, Suite 100, Oregon City, OR 97045-1572 | 2011-05-20 |
| 1396067773 | Providence Health & Services - Oregon | Clinic/Center | 1500 Division St, Oregon City, OR 97045-1527 | 2010-02-25 |
| 1194057497 | Providence Health & Services - Oregon | Clinic/Center | 1510 Division St, Ste 170, Oregon City, OR 97045-1581 | 2010-02-11 |
| 1821320128 | Providence Health & Services - Oregon | Clinic/Center | 1510 Division St, Ste 170, Oregon City, OR 97045-2551 | 2010-02-11 |
| 1891026647 | Providence Health & Services - Oregon | Clinic/Center | 1510 Division St, Suite 200, Oregon City, OR 97045-1599 | 2010-01-19 |
| 1669429262 | Allergy Asthma Clinic PC | Clinic/Center | 14279 Glen Oak Rd, Ste 204, Oregon City, OR 97045-8008 | 2006-05-28 |
| 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 |
| 1063069300 | Ideal Option Pllc | Clinic/Center | 863 Liberty St Ne, Salem, OR 97301-2451 | 2019-08-21 |
| Find all providers with the same taxonomy | ||||
| City | OREGON CITY |
| Zip Code | 97045 |
Please comment or provide details below to improve the information on PROVIDENCE HEALTH & SERVICES - OREGON.
| 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.