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

Providence Health & Services Oregon

Organization Psychiatry Physician · NPI 1093963209

Providence Health & Services Oregon is a Psychiatry Physician in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2008.

Licensed in
OR
In the registry since
2008
Specialties on file
6
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Practice location Address checks out

5251 NE Glisan St Bldg A 2ND Fl
Portland, OR 97213-3052
Phone: (503) 215-4860
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

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

Record details

NPI number1093963209
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Providence Medical Group; Providence Psychiatry East
NPI enumeratedAugust 29, 2008
Last updated in NPPESMay 26, 2026
Certification dateMay 26, 2026
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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