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

Providence Health & Services - Oregon

Organization Family Medicine Physician · NPI 1841466141

Providence Health & Services - Oregon is a Family Medicine Physician in Portland, Oregon. Registered with an NPI since 2008.

In the registry since
2008
Specialties on file
4
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Practice location Address checks out

5330 NE Glisan St Ste 100
Portland, OR 97213-3069
Phone: (503) 215-9706
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X
Clinic/Center Taxonomy 261Q00000X
Urgent Care Clinic/Center Taxonomy 261QU0200X

Record details

NPI number1841466141
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Asst Secretary Enrollment · (425) 358-9786
Other names Providence Medical Group; Providence Medical Group Glisan
NPI enumeratedMay 6, 2008
Last updated in NPPESJuly 4, 2025
Certification dateJuly 4, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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