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

Providence Health & Services - Oregon

Organization Hematology & Oncology Physician · NPI 1124325972

Providence Health & Services - Oregon is a Hematology & Oncology Physician in Portland, Oregon. Registered with an NPI since 2011.

In the registry since
2011
Specialties on file
2

Practice location Address checks out

4805 NE Glisan St Ste 11N
Portland, OR 97213-2933
Phone: (503) 215-1600
Fax: (503) 215-1600
Show map & directions

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

Specialties & licences

Hematology & Oncology Physician (primary) Taxonomy 207RH0003X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1124325972
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Providence Dysplasia Clinic; Providence Medical Group
NPI enumeratedFebruary 14, 2011
Last updated in NPPESMarch 23, 2026
Certification dateMarch 23, 2026
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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