PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1124129903
Family Medicine in Portland, OR

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

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since September 26, 2006

1321 NE 99TH AVE, SUITE 200, PORTLAND, OR 97220(503) 215-4250(503) 215-4255 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, Jun 10, 2024 and 1 more (4 updates tracked since 2020).

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About Providence Health & Services - Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1124129903), doing business as Providence Medical Group, is a healthcare organization registered as a family 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

NPI1124129903

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON

Location Address1321 NE 99TH AVE, SUITE 200Portland, OR 97220-9439

Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180 · (503) 215-6446 · Fax (503) 215-6644

Phone(503) 215-4250

Fax(503) 215-4255

Organization SubpartNo

Authorized OfficialDonald W AndersonAssistant Secretary Of Enrollments · (425) 358-9786

Enumeration DateSeptember 26, 2006

Last NPPES UpdateJune 20, 20254 updates tracked since enumeration

NPPES CertifiedJune 20, 2025

✔ NPI 1124129903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedClinic/CenterTaxonomy 261Q00000X

1321 NE 99TH AVE, Portland, OR 97220

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Other Names 2

Doing Business AsProvidence Medical Group

Doing Business AsProvidence Medical Group Gateway Family & Community Medicine

Other Identifiers 1

Medicaid022844OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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.

MARINA MEZEY MD

Family Medicine

1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 97220

Multnomah County (503) 215-4250

DR. JIMMY MING-YUH LIAO MD

Family Medicine

1321 NE 99TH AVE, SUITE 100
PORTLAND, OR 97220

Multnomah County (503) 215-9900

MS. NORI ALEA TREVARTHEN FNP

Nurse Practitioner (Family)

1321 NE 99TH AVE, STE 100
PORTLAND, OR 97220

Multnomah County (503) 215-9900

DR. STEVEN J MANDELBLATT M.D.

Internal Medicine

1321 NE 99TH AVE, SUITE 100
PORTLAND, OR 97220

Multnomah County (503) 215-9900

JODI K DEMUNTER MD

Family Medicine

1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 97220

Multnomah County (503) 215-4250

CRAIG L STEPHENS MD

Family Medicine

1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 97220

Multnomah County (503) 215-4250

DOLORES L FOGLIO FNP

Nurse Practitioner

1321 NE 99TH AVE, SUITE 100
PORTLAND, OR 97220

Multnomah County (503) 215-9900

MS. SARA J DAVIS-RISEN

Nurse Practitioner (Family)

1321 NE 99TH AVE, STE 100
PORTLAND, OR 97220

Multnomah County (503) 215-9900

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 1124129903. It was assigned to this organization in the NPPES registry on September 26, 2006. The provider is doing business as Providence Medical Group and Providence Medical Group Gateway Family & Community Medicine.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 1321 NE 99th Ave Suite 200, Portland, OR 97220. The listed phone number is (503) 215-4250.

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

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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.