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

Providence Health & Services - Oregon

Organization Neurology Physician · NPI 1013192806

Providence Health & Services - Oregon is a Neurology Physician in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2007.

Licensed in
OR
In the registry since
2007
Specialties on file
8
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Practice location Address checks out

9155 SW Barnes Rd Ste 333
Portland, OR 97225-6625
Phone: (503) 216-5102
Fax: (503) 216-2485
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X (OR)
Neurology Physician Taxonomy 2084N0400X
Child & Adolescent Psychiatry Physician Taxonomy 2084P0804X (OR)
Geriatric Psychiatry Physician Taxonomy 2084P0805X (OR)
Adult Mental Health Clinic/Center Taxonomy 261QM0850X
Adolescent and Children Mental Health Clinic/Center Taxonomy 261QM0855X
Nurse Practitioner Taxonomy 363L00000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X (OR)

Record details

NPI number1013192806
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Health & Services - Oregon
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Providence Medical Group; Providence Psychiatry West
NPI enumeratedDecember 31, 2007
Last updated in NPPESJune 20, 2025
Certification dateJune 20, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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