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

Providence Health & Services - Oregon

Organization Pediatric Surgery Physician · NPI 1659451086

Providence Health & Services - Oregon is a Pediatric Surgery Physician in Portland, Oregon. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

1321 NE 99th Ave Ste 200
Portland, OR 97220-9436
Phone: (503) 216-8654
Fax: (503) 216-8658
Show map & directions

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

Specialties & licences

Pediatric Surgery Physician (primary) Taxonomy 2086S0120X

Record details

NPI number1659451086
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Health & Services - Oregon
Authorized official Donald Anderson — Assistant Secreatry For Enrollment · (425) 358-9786
Other names Providence Medical Group; Providence Pediatric Specialties Iii
NPI enumeratedOctober 17, 2006
Last updated in NPPESJuly 4, 2025
Certification dateJuly 4, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

Other providers in Portland