PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1770723017
Dermatology in Tigard, OR

Active since February 26, 2009
18040 SW LOWER BOONES FERRY RD, SUITE 100, TIGARD, OR 97224(503) 216-0700 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Providence Health & Services - Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1770723017), doing business as Pmg Bridgeport Dermatology, is a healthcare organization registered as a dermatology in Tigard, Oregon and active in the NPI registry since February 2009. The organization lists Donald W Anderson, Assistant Secretary Enrollment, as its authorized official.

NPPES Registry Identity

NPI1770723017
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON
Location Address18040 SW LOWER BOONES FERRY RD, SUITE 100Tigard, OR 97224-7215
Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180
Organization SubpartYes
Authorized OfficialDonald W AndersonAssistant Secretary Enrollment · (425) 358-9786
Enumeration DateFebruary 26, 2009
Last NPPES UpdateJuly 1, 2025
NPPES CertifiedJuly 1, 2025
NPI 1770723017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedClinic/CenterTaxonomy 261Q00000X
18040 SW LOWER BOONES FERRY RD, Tigard, OR 97224

Other Names 2

Doing Business AsPmg Bridgeport Dermatology
Doing Business AsProvidence Medical 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.

Physician Assistant
18040 SW LOWER BOONES FERRY RD, SUITE 100
TIGARD, OR 97224
Clinic/Center
18040 SW LOWER BOONES FERRY RD, SUITE 104
PORTLAND, OR 97224
Physician Assistant
18040 SW LOWER BOONES FERRY RD
TIGARD, OR 97224
Family Medicine
18040 SW LOWER BOONES FERRY RD, STE 100
TIGARD, OR 97224
Family Medicine
18040 SW LOWER BOONES FERRY RD, SUITE 100
TIGARD, OR 97224
Clinic/Center
18040 SW LOWER BOONES FERRY RD, SUITE 207
TIGARD, OR 97224
Family Medicine
18040 SW LOWER BOONES FERRY RD, STE 100
TIGARD, OR 97224
Pharmacist
18040 SW LOWER BOONES FERRY RD
TIGARD, OR 97224

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 1770723017. It was assigned to this organization in the NPPES registry on February 26, 2009. The provider is doing business as Pmg Bridgeport Dermatology and Providence Medical Group.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 18040 SW Lower Boones Ferry Rd Suite 100, Tigard, OR 97224. The listed phone number is (503) 216-0700.

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

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

When was this NPI record last updated?

The NPPES record for Providence Health & Services - Oregon was last updated on July 1, 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.