PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1235479643
Internal Medicine - Sports Medicine in Portland, OR

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

The primary specialty registered for this NPI is Internal Medicine, specializing in Sports Medicine, with taxonomy code 207RS0010X.

Active since February 21, 2013

909 SW 18TH AVE, PORTLAND, OR 97205(503) 962-1946(503) 962-1925 Get Directions Write a Review

NPPES record last updated: July 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 4, 2025, May 16, 2025, Aug 20, 2021 (3 updates tracked since 2021).

On this page

About Providence Health & Services - Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1235479643), doing business as Providence Medical Group, is a healthcare organization registered as a sports medicine in Portland, Oregon and active in the NPI registry since February 2013. The organization lists Donald Wayne Anderson, Assistant Secreatry For Enrollment, as its authorized official.

NPPES Registry Identity

NPI1235479643

Entity TypeOrganization

Primary Taxonomy207RS0010X

Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON

Location Address909 SW 18TH AVEPortland, OR 97205-1705

Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180 · (503) 215-6494 · Fax (503) 215-6644

Phone(503) 962-1946

Fax(503) 962-1925

Organization SubpartNo

Authorized OfficialDonald Wayne AndersonAssistant Secreatry For Enrollment · (425) 358-9786

Enumeration DateFebruary 21, 2013

Last NPPES UpdateJuly 4, 20253 updates tracked since enumeration

NPPES CertifiedJuly 4, 2025

✔ NPI 1235479643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RS0010X

Definition

An internist trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual.

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedClinic/CenterTaxonomy 261Q00000X

909 SW 18TH AVE, Portland, OR 97205

Open in Google Maps ↗

Other Names 2

Doing Business AsProvidence Medical Group

Doing Business AsProvidence Medical Group Sports Care

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. RACHEL ANN FOX ATC, CPT

Specialist/Technologist (Athletic Trainer)