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 1568793313

Providence Health & Services - Oregon is a Family Medicine Physician in Lake Oswego, Oregon. Registered with an NPI since 2010.

In the registry since
2010
Specialties on file
2

Practice location Address checks out

17550 Provost St Ste 201
Lake Oswego, OR 97034-5199
Phone: (503) 513-3350
Fax: (503) 513-3355
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 number1568793313
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Enrollment · (425) 358-9786
Other names Providence Medical Group; Providence Medical Group West Linn; Providence Medical Group West Linn; Providence Medical Group At Marys Woods
NPI enumeratedJanuary 19, 2010
Last updated in NPPESMarch 23, 2026
Certification dateMarch 23, 2026
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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