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

Providence Health & Services - Oregon

Organization Physical Therapist · NPI 1104109677

Providence Health & Services - Oregon is a Physical Therapist in Vancouver, Washington. Licensed in Washington and Wisconsin. Registered with an NPI since 2011.

Licensed in
WA, WI
In the registry since
2011
Specialties on file
3
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Practice location Address checks out

3101 SE 192nd Ave Ste 104
Vancouver, WA 98683-1442
Phone: (360) 553-7480
Fax: (360) 553-7485
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X (WA)
Occupational Therapist Taxonomy 225X00000X (WA)
Speech-Language Pathologist Taxonomy 235Z00000X (WI)

Record details

NPI number1104109677
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Health & Services - Oregon
Authorized official Donald Anderson — Assistant Secretary Enrollments · (425) 358-9786
Other names Providence Rehab Services-Camas; Providence Rehab Services-Camas
NPI enumeratedSeptember 21, 2011
Last updated in NPPESMay 14, 2025
Certification dateMay 14, 2025
Mailing addressPo Box 3395, Portland, OR 97208-3395

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