PROVIDENCE HEALTH & SERVICES OREGON
NPI 1245330380
Family Medicine in Clackamas, OR

Q: What is Providence Health & Services Oregon's NPI number?

The NPI number for Providence Health & Services Oregon is 1245330380. It was assigned to this organization in the NPPES registry on September 25, 2006. The provider is doing business as Providence Medical Group and Providence Medical Group Sunnyside.

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 25, 2006

9290 SE SUNNYBROOK BLVD, SUITE 120, CLACKAMAS, OR 97015(503) 215-2110(503) 215-2115 Get Directions Write a Review

NPPES record last updated: June 20, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 20, 2025, May 16, 2025, Jul 9, 2018 (3 updates tracked since 2018).

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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 1245330380), doing business as Providence Medical Group, is a healthcare organization registered as a family medicine in Clackamas, Oregon and active in the NPI registry since September 2006. The organization lists Donald Wayne Anderson, Asst Corp Secretary For Enrollments, as its authorized official.

NPPES Registry Identity

NPI1245330380

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NamePROVIDENCE HEALTH & SERVICES OREGON

Location Address9290 SE SUNNYBROOK BLVD, SUITE 120Clackamas, OR 97015

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

Phone(503) 215-2110

Fax(503) 215-2115

Organization SubpartNo

Authorized OfficialDonald Wayne AndersonAsst Corp Secretary For Enrollments · (425) 358-9786

Enumeration DateSeptember 25, 2006

Last NPPES UpdateJune 20, 20253 updates tracked since enumeration

NPPES CertifiedJune 20, 2025

✔ NPI 1245330380 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

9290 SE SUNNYBROOK BLVD, Clackamas, OR 97015

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Other Names 2

Doing Business AsProvidence Medical Group

Doing Business AsProvidence Medical Group Sunnyside

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Providence Health & Services Oregon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

1,498

Medicare enrollment records show 1,498 clinicians reassign Medicare billing to Providence Health & Services Oregon, which bills Medicare for the services they deliver. Of these, 12 practice at this address and 684 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 56

Internal Medicine250

Family Practice212

Nurse Practitioner210

Hospitalist96

Neurology57

Obstetrics/Gynecology57

Physical Therapist in Private Practice54

Clinical Psychologist53

48 other specialties509

Nearest to this location (20)

See all 1,498

Melissa Arce, RD

Registered Dietitian or Nutrition Professional

NPI 1376206151

9290 SE SUNNYBROOK BLVD STE 120
Clackamas, OR 97015

(503) 215-2110

✔ Accepts MedicareSame address

Edmund Beck, MD

Family Practice

NPI 1508894718

9290 SE SUNNYBROOK BLVD SUITE 120
Clackamas, OR 97015

(503) 215-2110

✔ PECOS✔ Accepts MedicareSame address

Rachel Boneski, DO

Family Practice

NPI 1598261372

9290 SE SUNNYBROOK BLVD STE 120
Clackamas, OR 97015

(503) 215-2110

✔ PECOS✔ Accepts MedicareSame address

Gregory Garcia, MD

Internal Medicine

NPI 1922036219

9290 SE SUNNYBROOK BLVD SUITE 120
Clackamas, OR 97015

(503) 215-2110

✔ PECOS✔ Accepts MedicareSame address

Ewen Harrison, MD

Family Practice

NPI 1841647559

9290 SE SUNNYBROOK BLVD STE 120
Clackamas, OR 97015

(503) 215-2110

✔ PECOS✔ Accepts MedicareSame address

Brent Hoffman, D.O.

Family Practice

NPI 1841239076

9290 SE SUNNYBROOK BLVD SUITE 120
Clackamas, OR 97015

(503) 215-2110

✔ PECOS✔ Accepts MedicareSame address

Lauren Moore, DO

Family Practice

NPI 1528509445

9290 SE SUNNYBROOK BLVD STE 120
Clackamas, OR 97015

(503) 215-2110

✔ PECOS✔ Accepts MedicareSame address

Navin Nayak, MD

Internal Medicine

NPI 1063467181

9290 SE SUNNYBROOK BLVD SUITE 120
Clackamas, OR 97015

(503) 215-2110

✔ PECOS✔ Accepts MedicareSame address

Catherine Wagoner, MD

Pediatric Medicine

NPI 1487627550

9290 SE SUNNYBROOK BLVD STE 120
Clackamas, OR 97015

(503) 215-2110

✔ PECOSSame address

Rachel Gallagher, MD

Family Practice

NPI 1386349579

9290 SE SUNNYBROOK BLVD STE 120
Clackamas, OR 97015

(503) 215-2110

✔ PECOSSame address

Janet Ruzich, DO

Medical Oncology

NPI 1508869140

9280 SE SUNNYBROOK BLVD STE 200
Clackamas, OR 97015

(503) 513-1900

✔ PECOS✔ Accepts MedicareSame address

Alice Nayak, MD

Internal Medicine

NPI 1013962513

9290 SE SUNNYBROOK BLVD SUITE 120
Clackamas, OR 97015

(503) 215-2110

✔ PECOS✔ Accepts MedicareSame address

Jennifer Stager, MA CCC-SLP

Qualified Speech Language Pathologist

NPI 1154449858

10180 SE SUNNYSIDE RD
Clackamas, OR 97015

(800) 813-2000

✔ Accepts Medicare0.4 mi

John Steeh, D.O.

Emergency Medicine

NPI 1447359914

10180 S.E. SUNNYSIDE ROAD
Clackamas, OR 97015

(503) 652-2880

✔ PECOS✔ Accepts Medicare0.4 mi

Hayley Hirt, CNM

Certified Nurse Midwife (CNM)

NPI 1154935252

10100 SE SUNNYSIDE RD
Clackamas, OR 97015

(503) 813-2000

✔ PECOS0.5 mi

Zachary Pena, M.D.

Dermatology

NPI 1538592399

10151 SE SUNNYSIDE RD STE 240
Clackamas, OR 97015

(503) 962-1840

✔ PECOS✔ Accepts Medicare0.6 mi

Mary Clare Bohnett, MD

Dermatology

NPI 1710482013

10151 SE SUNNYSIDE RD STE 240
Clackamas, OR 97015

(503) 962-1840

✔ PECOS✔ Accepts Medicare0.6 mi

Andrew Touati, MD

Dermatology

NPI 1730671645

10151 SE SUNNYSIDE RD STE 240
Clackamas, OR 97015

(503) 962-1840

✔ PECOS✔ Accepts Medicare0.6 mi

Laura Milner, PSY. D

Clinical Psychologist

NPI 1144560582

11211 SE 82ND AVE SUITE O
Happy Valley, OR 97086

(503) 722-6200

✔ PECOS✔ Accepts Medicare1.1 mi

Edward Lin, D.O.

Family Practice

NPI 1659783546

5111 SE LAKE RD
Milwaukie, OR 97222

(503) 771-0055

✔ PECOS✔ Accepts Medicare2.0 mi

See all 1,498 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 1245330380. It was assigned to this organization in the NPPES registry on September 25, 2006. The provider is doing business as Providence Medical Group and Providence Medical Group Sunnyside.

Where is Providence Health & Services Oregon located?

Providence Health & Services Oregon is located at 9290 SE Sunnybrook Blvd Suite 120, Clackamas, OR 97015. The listed phone number is (503) 215-2110.

What is Providence Health & Services Oregon's specialty?

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

Is Providence Health & Services Oregon enrolled in Medicare?

Yes. Providence Health & Services Oregon is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Providence Health & Services Oregon?

According to the CMS Revalidation Reassignment List (October 2026 release), 1,498 clinicians in 56 Medicare specialties reassign their Medicare billing to Providence Health & Services Oregon. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (250), Family Practice (212) and Nurse Practitioner (210). Of these, 12 practice at this address and 684 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.