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PROVIDENCE HEALTH & SERVICES OREGON
NPI 1033804091
Psychiatry & Neurology - Addiction Psychiatry in Portland, OR

Active since April 06, 2023
4400 NE HALSEY ST, BLDG 2, STE 599, PORTLAND, OR 97213(503) 215-2110 Get Directions Write a Review

NPPES record last updated: June 20, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 20, 2025, May 15, 2025, Apr 4, 2024 and 1 more (4 updates tracked since 2023).

About Providence Health & Services Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES OREGON (NPI 1033804091), doing business as Providence Medical Group, is a healthcare organization registered as an addiction psychiatry in Portland, Oregon and active in the NPI registry since April 2023. The organization lists Donald Wayne Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1033804091
Entity TypeOrganization
Primary Taxonomy2084P0802X
Legal Business NamePROVIDENCE HEALTH & SERVICES OREGON
Location Address4400 NE HALSEY ST, BLDG 2, STE 599Portland, OR 97213-9721
Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180
Phone(503) 215-2110
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateApril 6, 2023
Last NPPES UpdateJune 20, 20254 updates tracked since enumeration
NPPES CertifiedJune 20, 2025
✔ NPI 1033804091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Addiction PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0802X
Definition
Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders.
4400 NE HALSEY ST, BLDG 2, Portland, OR 97213
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Other Names 1

Doing Business AsProvidence Medical Group

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

PROVIDENCE HEALTH & SERVICES OREGON
Physical Medicine & Rehabilitation
4400 NE HALSEY ST, BLDG 2, STE 599
PORTLAND, OR 97213
Multnomah County (032) 153-3005
PROVIDENCE HEALTH & SERVICES OREGON
Psychiatry & Neurology (Psychiatry)
4400 NE HALSEY ST, BLDG 2, STE 599
PORTLAND, OR 97213
Multnomah County (503) 215-3300
DR. CHANG MIN LEE MD
Internal Medicine
4400 NE HALSEY ST, BLDG 2, 3RD FLOOR
PORTLAND, OR 97213
Multnomah County (503) 215-0750

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 1033804091. It was assigned to this organization in the NPPES registry on April 6, 2023. The provider is doing business as Providence Medical Group.

Where is Providence Health & Services Oregon located?

Providence Health & Services Oregon is located at 4400 NE Halsey St, Bldg 2 Ste 599, Portland, OR 97213. The listed phone number is (503) 215-2110.

What is Providence Health & Services Oregon's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Addiction Psychiatry, with taxonomy code 2084P0802X.

When was this NPI record last updated?

The NPPES record for Providence Health & Services Oregon was last updated on June 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.