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

Providence Health & Services - Oregon

Organization Internal Medicine Physician · NPI 1093815243

Providence Health & Services - Oregon is an Internal Medicine Physician in Tigard, Oregon. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2

Practice location Address checks out

12442 SW Scholls Ferry Rd Ste 100
Tigard, OR 97223-3396
Phone: (503) 216-9200
Fax: (503) 216-9220
Show map & directions

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

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1093815243
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Providence Medical Group; Providence Medical Group Scholls; Providence Medical Group Scholls
NPI enumeratedSeptember 25, 2006
Last updated in NPPESJune 20, 2025
Certification dateJune 20, 2025
Mailing addressPo Box 31001-4180, Pasadena, CA 91110-4180

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