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

Providence Health & Services - Oregon

Organization Clinic/Center · NPI 1104246008

Providence Health & Services - Oregon is a Clinic/Center in Portland, Oregon. Registered with an NPI since 2014.

In the registry since
2014

Practice location Address checks out

18040 SW Lowr Boones Ferry RD Ste 104
Portland, OR 97224-7259
Phone: (855) 229-6490
Show map & directions

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

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1104246008
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Keenan Freeman — Cfo · (503) 893-6524
Other names Providence Medical Group; Providence Health Express At Bridgeport
NPI enumeratedApril 18, 2014
Last updated in NPPESJune 20, 2025
Certification dateJune 20, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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