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

Providence Health & Services - Oregon

Organization Emergency Medicine Physician · NPI 1861513731

Providence Health & Services - Oregon is an Emergency Medicine Physician in Portland, Oregon. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
3

Practice location Address checks out

15640 NW Laidlaw Rd Ste 102
Portland, OR 97229-3828
Phone: (503) 764-0100
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Emergency Medicine Physician Taxonomy 207P00000X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1861513731
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Enrollment · (425) 358-9786
Other names Pmg Bethany; Pmg Bethany; Providence Medical Group
NPI enumeratedApril 2, 2007
Last updated in NPPESJuly 4, 2025
Certification dateJuly 4, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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