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

Providence Health & Services Oregon

Organization End-Stage Renal Disease (ESRD) Treatment Clinic/Center · NPI 1396818993

Providence Health & Services Oregon is an End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Portland, Oregon. Registered with an NPI since 2006.

In the registry since
2006
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Practice location Address checks out

4805 NE Glisan St
Portland, OR 97213-2933
Phone: (503) 215-4323
Fax: (503) 215-0297
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

End-Stage Renal Disease (ESRD) Treatment Clinic/Center (primary) Taxonomy 261QE0700X

Record details

NPI number1396818993
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Health & Services - Oregon
Authorized official Donald Anderson — Assistant Secretary Enrollments · (425) 358-9786
Other names Providence Portland Medical Center; Providence Portland Medical Center
NPI enumeratedNovember 15, 2006
Last updated in NPPESMay 7, 2025
Certification dateMay 7, 2025
Mailing addressPo Box 3395, Portland, OR 97208-3395

Other providers in Portland