PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1447652797
Integrative Medicine in Portland, OR

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

The primary specialty registered for this NPI is Integrative Medicine with taxonomy code 202D00000X.

Active since September 18, 2014

4805 NE GLISAN ST, 1ST FLOOR, NORTH TOWER, PORTLAND, OR 97213(503) 215-3219 Get Directions Write a Review

NPPES record last updated: June 30, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 30, 2025, Sep 29, 2024 (2 updates tracked since 2024).

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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 1447652797), doing business as Providence Medical Group, is a healthcare organization registered as an integrative medicine in Portland, Oregon and active in the NPI registry since September 2014. The organization lists Donald Wayne Anderson, Assistant Secretary Enrollment, as its authorized official.

NPPES Registry Identity

NPI1447652797

Entity TypeOrganization

Primary Taxonomy202D00000X

Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON

Location Address4805 NE GLISAN ST, 1ST FLOOR, NORTH TOWERPortland, OR 97213-2933

Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180

Phone(503) 215-3219

Organization SubpartNo

Authorized OfficialDonald Wayne AndersonAssistant Secretary Enrollment · (425) 525-5392

Enumeration DateSeptember 18, 2014

Last NPPES UpdateJune 30, 20252 updates tracked since enumeration

NPPES CertifiedJune 30, 2025

✔ NPI 1447652797 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyIntegrative MedicineAllopathic & Osteopathic Physicians

Taxonomy Code202D00000X

Definition

A physician who specializes in the treatment of the whole person through prevention and treatment based on medical evidence. Integrative medicine considers all factors that influence health, wellness, and disease – including mind, body, and spirit. Conventional and alternative methods are used to facilitate the body’s innate healing response. Appropriate consideration is given to use of less-invasive and less-harmful interventions, when possible. It also incorporates all appropriate therapeutic approaches, health care modalities, and disciplines to achieve optimal health and healing.

Also ListedClinic/CenterTaxonomy 261Q00000X

4805 NE GLISAN ST, Portland, OR 97213

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Other Names 2

Doing Business AsProvidence Medical Group

Doing Business AsProvidence Integrative Medicine East

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, 136 practice at this address and 1,050 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

Bethany Adams, DNP, AGACNP

Nurse Practitioner

NPI 1053955047

4805 NE GLISAN ST
Portland, OR 97213

(503) 215-2392

✔ PECOS✔ Accepts MedicareSame address

Brett Baxter, MD

Hospitalist

NPI 1942246947

4805 NE GLISAN ST SUITE BG05
Portland, OR 97213

(503) 215-2392

✔ PECOS✔ Accepts MedicareSame address

Laura Bennetts, MD

Internal Medicine

NPI 1760006118

4805 NE GLISAN ST
Portland, OR 97213

(503) 215-2392

✔ PECOS✔ Accepts MedicareSame address

Austen Brown, M.D.

Emergency Medicine

NPI 1689094583

4805 NE GLISAN ST
Portland, OR 97213

(503) 215-1111

✔ PECOS✔ Accepts MedicareSame address

Andrea Buras, M.D.

Gynecological Oncology

NPI 1609130392

4805 NE GLISAN ST STE 11N
Portland, OR 97213

(503) 215-2075

✔ PECOS✔ Accepts MedicareSame address

William Chapin, MD

Endocrinology

NPI 1083653679

4805 NE GLISAN ST STE 6N40
Portland, OR 97213

(503) 215-6601

✔ PECOS✔ Accepts MedicareSame address

Alison Conlin, MD

Medical Oncology

NPI 1841460193

4805 NE GLISAN ST STE 6N50
Portland, OR 97213

(503) 215-5696

✔ PECOS✔ Accepts MedicareSame address

John Creasy, MD

Surgical Oncology

NPI 1336415140

4805 NE GLISAN ST STE 11N
Portland, OR 97213

(503) 215-8650

✔ PECOS✔ Accepts MedicareSame address

Nicole Crotty, REGISTERED DIETITIAN

Registered Dietitian or Nutrition Professional

NPI 1972075687

4805 NE GLISAN ST STE 6N40
Portland, OR 97213

(253) 569-1239

Same address

Daniel Davila Bradley, M.D.

General Surgery

NPI 1245587823

4805 NE GLISAN ST STE 6N60
Portland, OR 97213

(503) 935-8379

✔ PECOS✔ Accepts MedicareSame address

Fikayo Falodun, MD

Psychiatry

NPI 1467030932

4805 NE GLISAN ST
Portland, OR 97213

(503) 215-6199

✔ PECOS✔ Accepts MedicareSame address

Terena Gimmillaro, DO

Family Practice

NPI 1235574955

4805 NE GLISAN ST
Portland, OR 97213

(503) 215-4860

✔ PECOS✔ Accepts MedicareSame address

Rachel Hample, DMD

Dentist

NPI 1710730601

4805 NE GLISAN ST STE 11N
Portland, OR 97213

(503) 215-1676

✔ PECOS✔ Accepts MedicareSame address

Heidi Hansen, D.M.D.

Oral Medicinist

NPI 1063655967

4805 NE GLISAN ST STE 11N
Portland, OR 97213

(503) 215-1676

✔ PECOS✔ Accepts MedicareSame address

Christina Hoppe, PSYD

Clinical Psychologist

NPI 1942634134

4805 NE GLISAN ST STE 6N40
Portland, OR 97213

(503) 215-7230

✔ PECOS✔ Accepts MedicareSame address

Rui Li, M.D., PH.D

Hematology/Oncology

NPI 1689871535

4805 NE GLISAN ST SUITE 6N40
Portland, OR 97213

(503) 215-5696

✔ PECOS✔ Accepts MedicareSame address

Heather Merry, MD

Thoracic Surgery

NPI 1538278700

4805 NE GLISAN ST STE 6N50
Portland, OR 97213

(503) 215-2300

✔ PECOS✔ Accepts MedicareSame address

Meaghan Shanahan, M.D.

Obstetrics/Gynecology

NPI 1083844765

4805 NE GLISAN ST UNIT 3K
Portland, OR 97213

(503) 215-6150

✔ PECOS✔ Accepts MedicareSame address

Amber Watters, DDS

Orofacial Pain

NPI 1477786499

4805 NE GLISAN ST STE 11N
Portland, OR 97213

(503) 215-1676

✔ PECOS✔ Accepts MedicareSame address

Mark Whiteford, MD

Colorectal Surgery (Proctology)

NPI 1710970892

4805 NE GLISAN ST SUITE 6N60
Portland, OR 97213

(503) 281-0561

✔ PECOS✔ Accepts MedicareSame address

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 1447652797. It was assigned to this organization in the NPPES registry on September 18, 2014. The provider is doing business as Providence Medical Group and Providence Integrative Medicine East.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 4805 NE Glisan St 1st Floor, North Tower, Portland, OR 97213. The listed phone number is (503) 215-3219.

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

The primary specialty registered for this NPI is Integrative Medicine with taxonomy code 202D00000X.

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, 136 practice at this address and 1,050 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 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.