PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1013143478
Internal Medicine in Sherwood, OR

NPI Status: Active since May 29, 2009

Contact Information

16770 SW EDY RD
SUITE 102
SHERWOOD, OR
ZIP 97140
Phone: (503) 216-9600

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  • Organization
  • Internal Medicine
  • CLIA Number: 38D2203955
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 12-06-2026

About PROVIDENCE HEALTH & SERVICES - OREGON

This page provides the complete NPI Profile along with additional information for Providence Health & Services - Oregon, an internist established in Sherwood, Oregon operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1013143478 assigned on May 2009. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's . The authorized official of this NPI record is Mr. Donald W Anderson Jr. (Assistant Secretary Of Enrollments)

NPI
1013143478
Provider Legal Name
PROVIDENCE HEALTH & SERVICES - OREGON
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
16770 SW EDY RD SUITE 102 SHERWOOD, OR 97140
Location Phone
(503) 216-9600
Mailing Address
PO BOX 31001 - 4180 PASADENA, CA 91110
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-29-2009
Last Update Date
06-20-2025
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An internist like Providence Health & Services - Oregon is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1261Q00000XAmbulatory Health Care Facilities

Clinic/Center

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. DONALD W ANDERSON JR.

Authorized Official Title
ASSISTANT SECRETARY OF ENROLLMENTS
Authorized Official Phone
(425) 358-9786

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
500611226MEDICAID (05)OR 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
38D2203955
Facility Type
Physician Office
Certificate Effective Date
December 07, 2024
Certificate Expiration Date
December 06, 2026
Laboratory Director
LINDSAY SPARKS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Providence Health & Services - Oregon to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1013143478, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
1
Doubled → 2
Pos 4
3
Unchanged
Pos 5
1
Doubled → 2
Pos 6
4
Unchanged
Pos 7
3
Doubled → 6
Pos 8
4
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 1 → 2 3 → 6 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 2 + 3 + 2 + 4 + 6 + 4 + 1 + 4 + 24 = 52

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 52 is 60. The difference is the calculated check digit.

60 - 52 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1013143478.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Physician Assistant
16770 SW EDY RD, SUITE 102
SHERWOOD, OR 97140
Family Medicine
16770 SW EDY RD
SHERWOOD, OR 97140
Nurse Practitioner
16770 SW EDY RD
SHERWOOD, OR 97140
Clinic/Center (Podiatric)
16770 SW EDY RD, SUITE 216
SHERWOOD, OR 97140
Pediatrics
16770 SW EDY RD
SHERWOOD, OR 97140
Family Medicine
16770 SW EDY RD, SUITE 102
SHERWOOD, OR 97140
Internal Medicine
16770 SW EDY RD, SUITE 102
SHERWOOD, OR 97140
Pediatrics
16770 SW EDY RD, STE 102
SHERWOOD, OR 97140
Nurse Practitioner (Family)
16770 SW EDY RD
SHERWOOD, OR 97140
Family Medicine
16770 SW EDY RD, SUITE 102
SHERWOOD, OR 97140
Family Medicine
16770 SW EDY RD, SUITE 102
SHERWOOD, OR 97140
Family Medicine
16770 SW EDY RD
SHERWOOD, OR 97140
Physician Assistant
16770 SW EDY RD, SUITE 102
SHERWOOD, OR 97140
Family Medicine
16770 SW EDY RD
SHERWOOD, OR 97140
Physician Assistant
16770 SW EDY RD, #216
SHERWOOD, OR 97140
Nurse Practitioner (Family)
16770 SW EDY RD
SHERWOOD, OR 97140
Family Medicine
16770 SW EDY RD, SUITE 102
SHERWOOD, OR 97140
Nurse Practitioner (Family)
16770 SW EDY RD
SHERWOOD, OR 97140
Physical Therapist
16770 SW EDY RD
SHERWOOD, OR 97140
Registered Nurse (Ambulatory Care)
16770 SW EDY RD
SHERWOOD, OR 97140

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013143478, enumerated as an "organization" on May 29, 2009.

The provider is located at 16770 SW EDY RD SUITE 102 SHERWOOD, OR 97140 and the phone number is (503) 216-9600.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.