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

Providence Health & Services - Oregon

Organization Family Medicine Physician · NPI 1184977233

Providence Health & Services - Oregon is a Family Medicine Physician in Canby, Oregon. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
2

Practice location Address checks out

200 S Hazel Dell Way
Canby, OR 97013-7829
Phone: (503) 263-9500
Fax: (503) 263-1383
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1184977233
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 Canby Family Medicine
NPI enumeratedOctober 25, 2012
Last updated in NPPESJune 20, 2025
Certification dateJune 20, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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