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 1245330380

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

In the registry since
2006
Specialties on file
2

Practice location Address checks out

9290 SE Sunnybrook Blvd Ste 120
Clackamas, OR 97015
Phone: (503) 215-2110
Fax: (503) 215-2115
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 number1245330380
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Asst Corp Secretary For Enrollments · (425) 358-9786
Other names Providence Medical Group; Providence Medical Group Sunnyside
NPI enumeratedSeptember 25, 2006
Last updated in NPPESJune 20, 2025
Certification dateJune 20, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

Other providers in Clackamas