PROVIDENCE HEALTH & SERVICES OREGON
NPI 1104097906
Pediatrics in Longview, WA

Active since March 19, 2008
971 11TH AVE, LONGVIEW, WA 98632(360) 577-1771 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 16, 2025, Nov 13, 2018 (3 updates tracked since 2018).

About Providence Health & Services Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES OREGON (NPI 1104097906), doing business as Prov Peds Neurology Longview, is a healthcare organization registered as a pediatrics in Longview, Washington and active in the NPI registry since March 2008. The organization lists Donald Wayne Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1104097906
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NamePROVIDENCE HEALTH & SERVICES OREGON
Location Address971 11TH AVELongview, WA 98632-2503
Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180 · (503) 215-6494
Organization SubpartYesParent: Providence Health & Services - Oregon
Authorized OfficialDonald Wayne AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateMarch 19, 2008
Last NPPES UpdateJune 20, 20253 updates tracked since enumeration
NPPES CertifiedJune 20, 2025
NPI 1104097906 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedClinic/CenterTaxonomy 261Q00000X
971 11TH AVE, Longview, WA 98632

Other Names 2

Doing Business AsProv Peds Neurology Longview
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.

Pediatrics
971 11TH AVE
LONGVIEW, WA 98632
Pediatrics
971 11TH AVE
LONGVIEW, WA 98632
Case Manager/Care Coordinator
971 11TH AVE
LONGVIEW, WA 98632
Pediatrics
971 11TH AVE
LONGVIEW, WA 98632
Pediatrics
971 11TH AVE
LONGVIEW, WA 98632
Pediatrics
971 11TH AVE
LONGVIEW, WA 98632
Pediatrics
971 11TH AVE
LONGVIEW, WA 98632
Pediatrics
971 11TH AVE
LONGVIEW, WA 98632

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 1104097906. It was assigned to this organization in the NPPES registry on March 19, 2008. The provider is doing business as Prov Peds Neurology Longview and Providence Medical Group.

Where is Providence Health & Services Oregon located?

Providence Health & Services Oregon is located at 971 11th Ave, Longview, WA 98632. The listed phone number is (360) 577-1771.

What is Providence Health & Services Oregon's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

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.