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

Providence Health & Services - Oregon

Organization Obstetrics & Gynecology Physician · NPI 1013217975

Providence Health & Services - Oregon is an Obstetrics & Gynecology Physician in Portland, Oregon. Registered with an NPI since 2010.

In the registry since
2010
Specialties on file
2

Practice location Address checks out

4805 NE Glisan St Ste 11N
Portland, OR 97213-2933
Phone: (503) 215-2075
Fax: (503) 215-2077
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1013217975
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Enrollment · (425) 358-9786
Other names Providence Gynecologic Oncology Clinic; Providence Medical Group
NPI enumeratedOctober 26, 2010
Last updated in NPPESMarch 25, 2026
Certification dateMarch 25, 2026
Mailing addressPo Box 31001-4180, Pasadena, CA 91110-4180

Other providers in Portland