PROVIDENCE HEALTH & SERVICE - OREGON
NPI 1023738424
Program of All-Inclusive Care for the Elderly (PACE) Provider Organization in Portland, OR

NPI Status: Active since August 29, 2022

Contact Information

4400 NE HALSEY ST
BUILDING 1, STE 200
PORTLAND, OR
ZIP 97213
Phone: (503) 215-6556
Fax: (503) 215-0685

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  • Organization
  • Program of All-Inclusive Care for the El...
  • CLIA Number: 38D0973869
  • CLIA Cert. Type: Other - ELDERPLACE HEALTH AND SOC
  • CLIA Exp. Date: 05-21-2026

About PROVIDENCE HEALTH & SERVICE - OREGON

This page provides the complete NPI Profile along with additional information for Providence Health & Service - Oregon, a provider established in Portland, Oregon operating as a Program Of All-inclusive Care For The Elderly (pace) Provider Organization. The healthcare provider is registered in the NPI registry with number 1023738424 assigned on August 2022. The practitioner's primary taxonomy code is 251T00000X. 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 Donald Wayne Anderson (Assistant Secretary Of Enrollments)

NPI
1023738424
Provider Legal Name
PROVIDENCE HEALTH & SERVICE - OREGON
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
4400 NE HALSEY ST BUILDING 1, STE 200 PORTLAND, OR 97213
Location Phone
(503) 215-6556
Location Fax
(503) 215-0685
Mailing Address
4400 NE HALSEY ST BUILDING 1, STE 200 PORTLAND, OR 97213
Mailing Phone
(503) 215-6556
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
08-29-2022
Last Update Date
05-16-2025
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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

Program of All-Inclusive Care for the Elderly (PACE) Provider Organization

Taxonomy Code
251T00000X
Type
Agencies
Taxonomy Description
A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights.

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

DONALD WAYNE ANDERSON

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
005673MEDICAID (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
38D0973869
Facility Type
Other - ELDERPLACE HEALTH AND SOC
Certificate Effective Date
May 22, 2024
Certificate Expiration Date
May 21, 2026
Laboratory Director
PAMELA BOSA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Providence Health & Service - 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 1023738424, we treat the final digit (4) 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 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

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
2
Doubled → 4
Pos 4
3
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
3
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
4
Unchanged
Pos 9
2
Doubled → 4
Check
4
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 2 → 4 7 → 14 → 5 8 → 16 → 7 2 → 4

Step 2: Add all digits plus the NPI constant

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

2 + 0 + 4 + 3 + 1 + 4 + 3 + 1 + 6 + 4 + 4 + 24 = 56

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

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1023738424.

Other Providers at the Same Location


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

Pediatrics
4400 NE HALSEY ST, BUILDING 2, 3RD FLOOR
PORTLAND, OR 97213
Pharmacist (Pharmacotherapy)
4400 NE HALSEY ST, 4TH FLOOR
PORTLAND, OR 97213
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
4400 NE HALSEY ST, BUILDING 2, FOURTH FLOOR
PORTLAND, OR 97213
Pharmacist
4400 NE HALSEY ST, BUILDING 2, FOURTH FLOOR
PORTLAND, OR 97213
Pharmacist (Ambulatory Care)
4400 NE HALSEY ST
PORTLAND, OR 97213
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
4400 NE HALSEY ST, SUITE 490
PORTLAND, OR 97213
Pharmacist (Ambulatory Care)
4400 NE HALSEY ST, BUILDING 2, 4TH FLOOR
PORTLAND, OR 97213
Pharmacist (Ambulatory Care)
4400 NE HALSEY ST, BUILDING 2 SUITE 490
PORTLAND, OR 97213
Pharmacist (Ambulatory Care)
4400 NE HALSEY ST, 4TH FLOOR, BUILDING 2
PORTLAND, OR 97213
Nurse Practitioner (Family)
4400 NE HALSEY ST, BLDG 2, SUITE 400
PORTLAND, OR 97213
Registered Nurse (Administrator)
4400 NE HALSEY ST, POP2, 3RD FL
PORTLAND, OR 97213
Pharmacist
4400 NE HALSEY ST
PORTLAND, OR 97213
Pathology (Anatomic Pathology & Clinical Pathology)
4400 NE HALSEY ST
PORTLAND, OR 97213
Pathology (Anatomic Pathology & Clinical Pathology)
4400 NE HALSEY ST, BLDG #3 PATHOLOGY AND LABORATORY
PORTLAND, OR 97213
Registered Nurse
4400 NE HALSEY ST, BUILDING 1 STE 200
PORTLAND, OR 97213
Family Medicine
4400 NE HALSEY ST, BUILDING 2
PORTLAND, OR 97213
Pharmacist
4400 NE HALSEY ST
PORTLAND, OR 97213
Physical Therapy Assistant
4400 NE HALSEY ST
PORTLAND, OR 97213
Pharmacist
4400 NE HALSEY ST
PORTLAND, OR 97213
Internal Medicine
4400 NE HALSEY ST
PORTLAND, OR 97213

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1023738424, enumerated as an "organization" on August 29, 2022.

The provider is located at 4400 NE HALSEY ST BUILDING 1, STE 200 PORTLAND, OR 97213 and the phone number is (503) 215-6556.

Program of All-Inclusive Care for the Elderly (PACE) Provider Organization with taxonomy code 251T00000X.

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