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

Providence Health & Services - Oregon

Organization Neurology Physician · NPI 1336311554

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

In the registry since
2008
Specialties on file
4
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Practice location Address checks out

4805 NE Glisan St Ste 6N50
Portland, OR 97213-2933
Phone: (503) 216-1150
Fax: (503) 216-1066
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X
Clinic/Center Taxonomy 261Q00000X
Adult Health Nurse Practitioner Taxonomy 363LA2200X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1336311554
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Enrollment · (425) 358-9786
Other names Providence Medical Group; Providence Neurological Specialties Ppmc
NPI enumeratedMarch 27, 2008
Last updated in NPPESJuly 4, 2025
Certification dateJuly 4, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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