PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1104113380
Psychiatric Unit in Portland, OR

Active since July 07, 2011
4805 NE GLISAN ST, PORTLAND, OR 97213(503) 215-4323(503) 215-0297 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Providence Health & Services - Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1104113380), doing business as Providence Portland Medical Center - Child & Adolescent Psychiatric, is a healthcare organization registered as a psychiatric unit in Portland, Oregon and active in the NPI registry since July 2011. The organization lists Donald W Anderson, Assistant Secretary Enrollments, as its authorized official.

NPPES Registry Identity

NPI1104113380
Entity TypeOrganization
Primary Taxonomy273R00000X
Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON
Location Address4805 NE GLISAN STPortland, OR 97213-2933
Mailing AddressPo Box 3395Portland, OR 97208-3395 · (503) 215-4323 · Fax (503) 215-0297
Fax(503) 215-0297
Organization SubpartYesParent: Providence Health & Services - Washington
Authorized OfficialDonald W AndersonAssistant Secretary Enrollments · (425) 358-9786
Enumeration DateJuly 7, 2011
Last NPPES UpdateMay 7, 2025
NPPES CertifiedMay 7, 2025
NPI 1104113380 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychiatric UnitHospital Units
Taxonomy Code273R00000X
License Licensed in OR · 023981
Definition
In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning.
Also ListedGeneral Acute Care HospitalTaxonomy 282N00000X · License 023981 (OR)
4805 NE GLISAN ST, Portland, OR 97213

Other Names 1

Doing Business AsProvidence Portland Medical Center - Child & Adolescent Psychiatric

Other Identifiers 2

Medicaid023981OR
Medicaid500400190OR

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.

Internal Medicine
4805 NE GLISAN ST
PORTLAND, OR 97213
General Acute Care Hospital
4805 NE GLISAN ST
PORTLAND, OR 97213
Emergency Medicine
4805 NE GLISAN ST
PORTLAND, OR 97213
Nurse Anesthetist, Certified Registered
4805 NE GLISAN ST
PORTLAND, OR 97213
Psychiatric Unit
4805 NE GLISAN ST
PORTLAND, OR 97213
Hospitalist
4805 NE GLISAN ST, STE BG05
PORTLAND, OR 97213
Doula
4805 NE GLISAN ST
PORTLAND, OR 97213
Nurse's Aide
4805 NE GLISAN ST
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 1104113380. It was assigned to this organization in the NPPES registry on July 7, 2011. The provider is doing business as Providence Portland Medical Center - Child & Adolescent Psychiatric.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 4805 NE Glisan St, Portland, OR 97213. The listed phone number is (503) 215-4323.

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

The primary specialty registered for this NPI is Psychiatric Unit with taxonomy code 273R00000X.

When was this NPI record last updated?

The NPPES record for Providence Health & Services - Oregon was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.