PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1013217975
Obstetrics & Gynecology in Portland, OR

Active since October 26, 2010
4805 NE GLISAN ST STE 11N, PORTLAND, OR 97213(503) 215-2075(503) 215-2077 Get Directions Write a Review

NPPES record last updated: March 25, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 25, 2026, Jun 20, 2025, May 16, 2025 (3 updates tracked since 2025).

About Providence Health & Services - Oregon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1013217975), doing business as Providence Gynecologic Oncology Clinic, is a healthcare organization registered as an obstetrics & gynecology in Portland, Oregon and active in the NPI registry since October 2010. The organization lists Donald Wayne Anderson, Assistant Secretary Enrollment, as its authorized official.

NPPES Registry Identity

NPI1013217975
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON
Location Address4805 NE GLISAN ST STE 11NPortland, OR 97213-2933
Mailing AddressPo Box 31001-4180Pasadena, CA 91110-4180
Fax(503) 215-2077
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAssistant Secretary Enrollment · (425) 358-9786
Enumeration DateOctober 26, 2010
Last NPPES UpdateMarch 25, 20263 updates tracked since enumeration
NPPES CertifiedMarch 25, 2026
NPI 1013217975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Also ListedClinic/CenterTaxonomy 261Q00000X
4805 NE GLISAN ST STE 11N, Portland, OR 97213

Other Names 2

Doing Business AsProvidence Gynecologic Oncology Clinic
Doing Business AsProvidence Medical Group

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Gerontology)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Oral Medicine
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Internal Medicine (Hospice and Palliative Medicine)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Internal Medicine (Hematology & Oncology)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Internal Medicine (Medical Oncology)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Nurse Practitioner (Gerontology)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Internal Medicine (Hospice and Palliative Medicine)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Internal Medicine (Hematology & Oncology)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Health & Services - Oregon's NPI number?

The NPI number for Providence Health & Services - Oregon is 1013217975. It was assigned to this organization in the NPPES registry on October 26, 2010. The provider is doing business as Providence Gynecologic Oncology Clinic and Providence Medical Group.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 4805 NE Glisan St Ste 11N, Portland, OR 97213. The listed phone number is (503) 215-2075.

What is Providence Health & Services - Oregon's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

When was this NPI record last updated?

The NPPES record for Providence Health & Services - Oregon was last updated on March 25, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.