PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1124325972
Internal Medicine - Hematology & Oncology in Portland, OR

NPI Status: Active since February 14, 2011

Contact Information

4805 NE GLISAN ST STE 11N
PORTLAND, OR
ZIP 97213
Phone: (503) 215-1600
Fax: (503) 215-1600

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  • Organization
  • Internal Medicine
  • Hematology & Oncology

About PROVIDENCE HEALTH & SERVICES - OREGON

This page provides the complete NPI Profile along with additional information for Providence Health & Services - Oregon, an internist established in Portland, Oregon operating as a Internal Medicine, focusing in hematology & oncology . The healthcare provider is registered in the NPI registry with number 1124325972 assigned on February 2011. The practitioner's primary taxonomy code is 207RH0003X. The provider is registered as an organization and their NPI record was last updated March 2026. The provider's . The authorized official of this NPI record is Donald Wayne Anderson Jr. (Assistant Secretary Of Enrollments)

NPI
1124325972
Provider Legal Name
PROVIDENCE HEALTH & SERVICES - OREGON
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
4805 NE GLISAN ST STE 11N PORTLAND, OR 97213
Location Phone
(503) 215-1600
Location Fax
(503) 215-1600
Mailing Address
PO BOX 31001 - 4180 PASADENA, CA 91110
Mailing Phone
(503) 215-6494
Mailing Fax
(503) 215-1600
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-14-2011
Last Update Date
03-23-2026
Code Navigator

An internist like Providence Health & Services - Oregon is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine Hematology & Oncology

Taxonomy Code
207RH0003X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1261Q00000XAmbulatory Health Care Facilities

Clinic/Center

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DONALD WAYNE ANDERSON JR.

Authorized Official Title
ASSISTANT SECRETARY OF ENROLLMENTS
Authorized Official Phone
(425) 358-9786

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
500632601MEDICAID (05)OR 

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1124325972, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
2
Doubled → 4
Pos 4
4
Unchanged
Pos 5
3
Doubled → 6
Pos 6
2
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
9
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 3 → 6 5 → 10 → 1 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 4 + 4 + 6 + 2 + 1 + 0 + 9 + 1 + 4 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1124325972.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Internal Medicine (Hematology & Oncology)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Nurse Practitioner (Gerontology)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Oral & Maxillofacial Surgery
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Internal Medicine (Medical Oncology)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Internal Medicine (Hematology & Oncology)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Obstetrics & Gynecology (Gynecologic Oncology)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Obstetrics & Gynecology (Gynecologic Oncology)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Internal Medicine (Medical Oncology)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Nurse Practitioner
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Radiology (Vascular & Interventional Radiology)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Physician Assistant
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Nurse Practitioner (Family)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Nurse Practitioner (Gerontology)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Internal Medicine (Hospice and Palliative Medicine)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Obstetrics & Gynecology
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Thoracic Surgery (Cardiothoracic Vascular Surgery)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Nurse Practitioner (Family)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Physician Assistant
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Oral Medicine
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213
Dentist (Orofacial Pain)
4805 NE GLISAN ST STE 11N
PORTLAND, OR 97213

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124325972, enumerated as an "organization" on February 14, 2011.

The provider is located at 4805 NE GLISAN ST STE 11N PORTLAND, OR 97213 and the phone number is (503) 215-1600.

Internal Medicine with taxonomy code 207RH0003X and a focus in Hematology & Oncology.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.