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

Providence Health & Services - Oregon

Organization Clinical Genetics (M.D.) Physician · NPI 1548676141

Providence Health & Services - Oregon is a Clinical Genetics (M.D.) Physician in Portland, Oregon. Registered with an NPI since 2014.

In the registry since
2014
Specialties on file
2

Practice location Address checks out

4805 NE Glisan St Ste 11N
Portland, OR 97213-2933
Phone: (503) 215-7901
Fax: (503) 215-7904
Show map & directions

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

Specialties & licences

Clinical Genetics (M.D.) Physician (primary) Taxonomy 207SG0201X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1548676141
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Enrollment · (425) 358-9786
Other names Providence Medical Group; Providence Genetic Risk Assessmet East
NPI enumeratedJuly 3, 2014
Last updated in NPPESMarch 23, 2026
Certification dateMarch 23, 2026
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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