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

Providence Health System Oregon

Organization Multi-Specialty Clinic/Center · NPI 1023098118

Providence Health System Oregon is a Multi-Specialty Clinic/Center in Portland, Oregon. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

4540 NE Glisan St
Portland, OR 97213-2333
Phone: (503) 215-3738
Fax: (503) 215-6942
Show map & directions

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

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X

Record details

NPI number1023098118
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollment · (425) 358-9786
Other names Providence Elder Place Portland
NPI enumeratedJanuary 17, 2006
Last updated in NPPESMay 16, 2025
Certification dateMay 16, 2025
Mailing address13007 Ne Glisan St, Portland, OR 97230-2545

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