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

Providence Health & Services - Oregon

Organization Cardiovascular Disease Physician · NPI 1235595299

Providence Health & Services - Oregon is a Cardiovascular Disease Physician in Ilwaco, Washington. Registered with an NPI since 2016.

In the registry since
2016
Specialties on file
2

Practice location Address checks out

174 1st Ave N
Ilwaco, WA 98624-9137
Phone: (503) 717-7850
Fax: (503) 216-0775
Show map & directions

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

Specialties & licences

Cardiovascular Disease Physician (primary) Taxonomy 207RC0000X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1235595299
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secreatry For Enrollment · (425) 358-9786
Other names Providence Medical Group; Providence St Vincent Heart Care Clinic Ilwaco
NPI enumeratedJanuary 6, 2016
Last updated in NPPESJuly 4, 2025
Certification dateJuly 4, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180