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

Providence Health & Services - Oregon

Organization Otolaryngology Physician · NPI 1083963573

Providence Health & Services - Oregon is an Otolaryngology Physician in The Dalles, Oregon. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
2

Practice location Address checks out

1815 E 19th St Ste 1
The Dalles, OR 97058-3385
Phone: (541) 298-5563
Show map & directions

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

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1083963573
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Providence Medical Group; Providence The Dalles Ent
NPI enumeratedAugust 30, 2012
Last updated in NPPESJune 20, 2025
Certification dateJune 20, 2025
Mailing addressPo Box 31001-4180, Pasadena, CA 91110-4118

Other providers in The Dalles