PROVIDENCE PORTLAND MEDICAL CENTER
NPI 1316199987
Nurse Practitioner in Portland, OR

Active since October 15, 2008
4805 NE GLISAN ST, PORTLAND, OR 97213(503) 215-6185 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Providence Portland Medical Center NPPES

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

PROVIDENCE PORTLAND MEDICAL CENTER (NPI 1316199987), doing business as Prov Nurse Practitioners East, is a healthcare organization registered as a nurse practitioner in Portland, Oregon and active in the NPI registry since October 2008. The organization lists Donald W Anderson, Assistant Secretary Enrollments, as its authorized official.

NPPES Registry Identity

NPI1316199987
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NamePROVIDENCE PORTLAND MEDICAL CENTER
Location Address4805 NE GLISAN STPortland, OR 97213-2933
Mailing AddressPo Box 3158Portland, OR 97208-3158
Organization SubpartNo
Authorized OfficialDonald W AndersonAssistant Secretary Enrollments · (425) 358-9786
Enumeration DateOctober 15, 2008
Last NPPES UpdateMay 7, 2025
NPPES CertifiedMay 7, 2025
NPI 1316199987 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

4805 NE GLISAN ST, Portland, OR 97213

Other Names 1

Doing Business AsProv Nurse Practitioners East

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 20

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

Internal Medicine
4805 NE GLISAN ST
PORTLAND, OR 97213
General Acute Care Hospital
4805 NE GLISAN ST
PORTLAND, OR 97213
Emergency Medicine
4805 NE GLISAN ST
PORTLAND, OR 97213
Nurse Anesthetist, Certified Registered
4805 NE GLISAN ST
PORTLAND, OR 97213
Psychiatric Unit
4805 NE GLISAN ST
PORTLAND, OR 97213
Hospitalist
4805 NE GLISAN ST, STE BG05
PORTLAND, OR 97213
Doula
4805 NE GLISAN ST
PORTLAND, OR 97213
Nurse's Aide
4805 NE GLISAN ST
PORTLAND, OR 97213

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 Portland Medical Center's NPI number?

The NPI number for Providence Portland Medical Center is 1316199987. It was assigned to this organization in the NPPES registry on October 15, 2008. The provider is doing business as Prov Nurse Practitioners East.

Where is Providence Portland Medical Center located?

Providence Portland Medical Center is located at 4805 NE Glisan St, Portland, OR 97213. The listed phone number is (503) 215-6185.

What is Providence Portland Medical Center's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Providence Portland Medical Center was last updated on May 7, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.