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PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1316125149
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Portland, OR

Active since February 04, 2008
9427 SW BARNES RD STE 395, PORTLAND, OR 97225(503) 216-1280(503) 216-1288 Get Directions Write a Review

NPPES record last updated: July 4, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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

About Providence Health & Services - Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1316125149), doing business as Providence Medical Group, is a healthcare organization registered as a neurology with special qualifications in child neurology in Portland, Oregon and active in the NPI registry since February 2008. The organization lists Donald Wayne Anderson, Assistant Secretary Enrollment, as its authorized official.

NPPES Registry Identity

NPI1316125149
Entity TypeOrganization
Primary Taxonomy2084N0402X
Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON
Location Address9427 SW BARNES RD STE 395Portland, OR 97225-6652
Mailing AddressPo Box 3158Portland, OR 97208-3158
Phone(503) 216-1280
Fax(503) 216-1288
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAssistant Secretary Enrollment · (425) 358-9786
Enumeration DateFebruary 4, 2008
Last NPPES UpdateJuly 4, 20253 updates tracked since enumeration
NPPES CertifiedJuly 4, 2025
✔ NPI 1316125149 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Neurology with Special Qualifications in Child NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0402X
Definition
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
Also ListedClinic/CenterTaxonomy 261Q00000X
9427 SW BARNES RD STE 395, Portland, OR 97225
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Other Names 2

Doing Business AsProvidence Medical Group
Doing Business AsProvidence Pediatric Neurology Mjp

Other Identifiers 1

Medicaid279056OR

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.

TYSON DEE PAYNE PAYNE PSYD
Psychologist (Clinical)
9427 SW BARNES RD STE 395
PORTLAND, OR 97225
Washington County (503) 216-6550
VICTORIA EUGENIE JANSEN RD
Dietitian, Registered
9427 SW BARNES RD STE 395
PORTLAND, OR 97225
Washington County (503) 216-6050
MISS NICOLE ASHLEIGH DALTON PSYD
Psychologist (Clinical)
9427 SW BARNES RD STE 395
PORTLAND, OR 97225
Washington County (503) 216-6550
ANGELA ELAINE SANTIAGO LENNON MD
Pediatrics (Pediatric Endocrinology)
9427 SW BARNES RD STE 395
PORTLAND, OR 97225
Washington County (503) 216-6050
GILLIAN C ROSICKY
Nurse Practitioner (Family)
9427 SW BARNES RD STE 395
PORTLAND, OR 97225
Washington County (503) 216-6550
AUSTIN D LAYTON DO
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
9427 SW BARNES RD STE 395
PORTLAND, OR 97225
Washington County (503) 216-6050
MR. RENJITH RADHAKRISHNAN NAIR AGACNP
Nurse Practitioner (Acute Care)
9427 SW BARNES RD STE 395
PORTLAND, OR 97225
Washington County (503) 962-1000
SHANIK J FERNANDO MD
Otolaryngology (Pediatric Otolaryngology)
9427 SW BARNES RD STE 395
PORTLAND, OR 97225
Washington County (503) 216-6050

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 1316125149. It was assigned to this organization in the NPPES registry on February 4, 2008. The provider is doing business as Providence Medical Group and Providence Pediatric Neurology Mjp.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 9427 SW Barnes Rd Ste 395, Portland, OR 97225. The listed phone number is (503) 216-1280.

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

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology with Special Qualifications in Child Neurology, with taxonomy code 2084N0402X.

When was this NPI record last updated?

The NPPES record for Providence Health & Services - Oregon was last updated on July 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.