PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1073604955
Internal Medicine in Portland, OR

Active since September 27, 2006
1321 NE 99TH AVE, SUITE 100, PORTLAND, OR 97220(503) 215-9900(503) 215-4055 Get Directions Write a Review

NPPES record last updated: June 20, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 20, 2025, May 15, 2025, Sep 24, 2020 (3 updates tracked since 2020).

About Providence Health & Services - Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1073604955), doing business as Providence Medical Group, is a healthcare organization registered as an internal medicine in Portland, Oregon and active in the NPI registry since September 2006. The organization lists Donald W Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1073604955
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON
Location Address1321 NE 99TH AVE, SUITE 100Portland, OR 97220-9437
Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180 · (503) 215-6494 · Fax (503) 215-6644
Fax(503) 215-4055
Organization SubpartNo
Authorized OfficialDonald W AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateSeptember 27, 2006
Last NPPES UpdateJune 20, 20253 updates tracked since enumeration
NPPES CertifiedJune 20, 2025
NPI 1073604955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition

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.

Also ListedClinic/CenterTaxonomy 261Q00000X
1321 NE 99TH AVE, Portland, OR 97220

Other Names 2

Doing Business AsProvidence Medical Group
Doing Business AsProvidence Medical Group Gateway Immediate Care

Other Identifiers 1

Medicaid198127OR

Accepted Insurance

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.

Family Medicine
1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 97220
Family Medicine
1321 NE 99TH AVE, STE 100
PORTLAND, OR 97220
Family Medicine
1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 97220
Family Medicine
1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 97220
Internal Medicine
1321 NE 99TH AVE, STE 200
PORTLAND, OR 97220
Family Medicine
1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 97220
Family Medicine
1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 97220
Nurse Practitioner (Family)
1321 NE 99TH AVE, SUITE 100
PORTLAND, OR 97220

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 1073604955. It was assigned to this organization in the NPPES registry on September 27, 2006. The provider is doing business as Providence Medical Group and Providence Medical Group Gateway Immediate Care.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 1321 NE 99th Ave Suite 100, Portland, OR 97220. The listed phone number is (503) 215-9900.

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

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

What insurance does Providence Health & Services - Oregon accept?

Health plans from Providence Health Plan list Providence Health & Services - Oregon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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 with the weekly NPPES data releases published by CMS.