1. Home
  2. Directory
  3. Oregon
  4. Portland
  5. Thoracic Surgery Cardiothoracic Vascular Surgery
  6. NPI Profile

PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1396019451
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Portland, OR

Active since March 06, 2012
4805 NE GLISAN ST, STE 6N50, PORTLAND, OR 97213(503) 215-2300 Get Directions Write a Review

NPPES record last updated: June 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 30, 2025, May 16, 2025, Aug 5, 2024 (3 updates tracked since 2024).

About Providence Health & Services - Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1396019451), doing business as Providence Medical Group, is a healthcare organization registered as a thoracic surgery (cardiothoracic vascular surgery) in Portland, Oregon and active in the NPI registry since March 2012. The organization lists Donald Wayne Anderson, Assistant Secretary Enrollment, as its authorized official.

NPPES Registry Identity

NPI1396019451
Entity TypeOrganization
Primary Taxonomy208G00000X
Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON
Location Address4805 NE GLISAN ST, STE 6N50Portland, OR 97213-2933
Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180
Phone(503) 215-2300
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAssistant Secretary Enrollment · (425) 358-9786
Enumeration DateMarch 6, 2012
Last NPPES UpdateJune 30, 20253 updates tracked since enumeration
NPPES CertifiedJune 30, 2025
✔ NPI 1396019451 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
Also ListedClinic/CenterTaxonomy 261Q00000X
4805 NE GLISAN ST, Portland, OR 97213
Open in Google Maps ↗

Other Names 2

Doing Business AsProvidence Medical Group
Doing Business AsProvidence Thoracic Surgery

Other Identifiers 1

Medicaid500644062OR

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.

SALONA SHRESTHA MD
Internal Medicine
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 215-2392
PROVIDENCE HEALTH & SERVICES - OREGON
General Acute Care Hospital
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 451-3000
DR. ROBERT THOMAS MARTIN M.D.
Emergency Medicine
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 297-6334
CECILIA BRADFORD CRNA
Nurse Anesthetist, Certified Registered
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 215-1111
PROVIDENCE HEALTH & SERVICES - OREGON
Psychiatric Unit
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 215-4323
GITA D GELFER DO
Hospitalist
4805 NE GLISAN ST, STE BG05
PORTLAND, OR 97213
Multnomah County (503) 215-2392
MECCA CARTER
Doula
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 215-1111
JESUS ERNESTO CONRIQUE GARCIA
Nurse's Aide
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 215-1111

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 1396019451. It was assigned to this organization in the NPPES registry on March 6, 2012. The provider is doing business as Providence Medical Group and Providence Thoracic Surgery.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 4805 NE Glisan St Ste 6n50, Portland, OR 97213. The listed phone number is (503) 215-2300.

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

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

When was this NPI record last updated?

The NPPES record for Providence Health & Services - Oregon was last updated on June 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.