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

Providence Health & Services - Oregon

Organization Cardiovascular Disease Physician · NPI 1578854857

Providence Health & Services - Oregon is a Cardiovascular Disease Physician in Portland, Oregon. Works from 2 locations. Registered with an NPI since 2011.

In the registry since
2011
Specialties on file
3
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Practice location Address checks out

4400 NE Halsey St Ste 102
Portland, OR 97213-1545
Phone: (503) 962-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1111 Ne 99th Ave, Portland, OR 97220-9442 — (503) 962-1000

Specialties & licences

Cardiovascular Disease Physician (primary) Taxonomy 207RC0000X
Clinic/Center Taxonomy 261Q00000X
Multi-Specialty Clinic/Center Taxonomy 261QM1300X

Record details

NPI number1578854857
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Providence Medical Group; Providence Heart Clinic Hollywood; Providence Heart Clinic At The Oregon Clinic Gateway; Providence Heart Clinic At The Oregon Clinic Gateway
NPI enumeratedApril 21, 2011
Last updated in NPPESMarch 23, 2026
Certification dateMarch 23, 2026
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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