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

Providence Health & Services - Oregon

Organization Anesthesiology Physician · NPI 1740732650

Providence Health & Services - Oregon is an Anesthesiology Physician in Portland, Oregon. Registered with an NPI since 2016.

In the registry since
2016
Specialties on file
6
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Practice location Address checks out

4805 NE Glisan St
Portland, OR 97213-2933
Phone: (503) 215-1111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Pathology Physician (primary) Taxonomy 207ZC0006X
Anesthesiology Physician Taxonomy 207L00000X
Emergency Medicine Physician Taxonomy 207P00000X
Family Medicine Physician Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Body Imaging Physician Taxonomy 2085B0100X

Record details

NPI number1740732650
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Enrollments · (425) 358-9786
Other names Providence Portland Medical Center
NPI enumeratedOctober 26, 2016
Last updated in NPPESMay 14, 2025
Certification dateMay 14, 2025
Mailing addressPo Box 31001-4199, Pasadena, CA 91110-4199

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