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

Providence Health & Services - Oregon

Organization Family Medicine Physician · NPI 1184729329

Providence Health & Services - Oregon is a Family Medicine Physician in Sherwood, Oregon. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
6
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Practice location Address checks out

16770 SW Edy Rd Ste 102
Sherwood, OR 97140-9679
Phone: (503) 216-9600
Fax: (503) 216-9650
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X
Pediatrics Physician Taxonomy 208000000X
Child & Adolescent Psychiatry Physician Taxonomy 2084P0804X
Geriatric Psychiatry Physician Taxonomy 2084P0805X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1184729329
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 Sherwood
NPI enumeratedSeptember 13, 2006
Last updated in NPPESJune 20, 2025
Certification dateJune 20, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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