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 1194013144

Providence Health & Services - Oregon is a Family Medicine Physician in Battle Ground, Washington. Works from 2 locations. Registered with an NPI since 2011.

In the registry since
2011
Specialties on file
3
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Practice location Address checks out

101 NW 12th Ave Ste 107
Battle Ground, WA 98604-9141
Phone: (360) 666-4480
Fax: (360) 666-4485
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3101 Se 192nd Ave Ste 103, Vancouver, WA 98683-1443 — (360) 666-4480

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1194013144
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 Battle Ground Family Medicine
NPI enumeratedJuly 12, 2011
Last updated in NPPESJune 20, 2025
Certification dateJune 20, 2025
Mailing addressPo Box 31001-4180, Pasadena, CA 91110-4180

Other providers in Battle Ground