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

Providence Health & Services - Oregon

Organization Pediatrics Physician · NPI 1194996991

Providence Health & Services - Oregon is a Pediatrics Physician in Bend, Oregon. Registered with an NPI since 2008.

In the registry since
2008
Specialties on file
2

Practice location Address checks out

2200 NE Professional Ct
Bend, OR 97701-6063
Phone: (541) 389-6313
Show map & directions

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

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1194996991
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Enrollment · (425) 358-9786
Other names Providence Medical Group; Providence Pediatric Neurology Bend
NPI enumeratedMarch 19, 2008
Last updated in NPPESJuly 4, 2025
Certification dateJuly 4, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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