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

Providence Health & Services - Oregon

Organization Cardiovascular Disease Physician · NPI 1790025104

Providence Health & Services - Oregon is a Cardiovascular Disease Physician in Portland, Oregon. Registered with an NPI since 2013.

In the registry since
2013
Specialties on file
2

Practice location Address checks out

4805 NE Glisan St Ste 1G08
Portland, OR 97213-2933
Phone: (503) 962-1000
Fax: (503) 962-1005
Show map & directions

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

Specialties & licences

Cardiovascular Disease Physician (primary) Taxonomy 207RC0000X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1790025104
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Enrollment · (425) 358-9786
Other names Providence Medical Group; Providence Heart Clinic East At Ppmc
NPI enumeratedFebruary 21, 2013
Last updated in NPPESJuly 1, 2025
Certification dateJuly 1, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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