Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Providence Health & Service - Oregon

Organization Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · NPI 1457625501

Providence Health & Service - Oregon is a Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Portland, Oregon. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
2
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Practice location Address checks out

5050 NE Hoyt St Ste 511
Portland, OR 97213-2984
Phone: (503) 962-1020
Fax: (503) 962-1021
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (primary) Taxonomy 208G00000X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1457625501
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Enrollment · (425) 358-9786
Other names Providence Medical Group; Providence Heart Clinic Cardiovascular Surgery East
NPI enumeratedMarch 6, 2012
Last updated in NPPESJune 30, 2025
Certification dateJune 30, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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