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PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1790025104
Internal Medicine - Cardiovascular Disease in Portland, OR

Active since February 21, 2013
4805 NE GLISAN ST, SUITE 1G08, PORTLAND, OR 97213(503) 962-1000(503) 962-1005 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: August 02, 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 1790025104), doing business as Providence Medical Group, is a healthcare organization registered as a cardiovascular disease in Portland, Oregon and active in the NPI registry since February 2013. The organization lists Donald W Anderson, Assistant Secretary Enrollment, as its authorized official.

NPPES Registry Identity

NPI1790025104
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON
Location Address4805 NE GLISAN ST, SUITE 1G08Portland, OR 97213-2933
Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180 · (503) 215-6494 · Fax (503) 215-6644
Phone(503) 962-1000
Fax(503) 962-1005
Organization SubpartNo
Authorized OfficialDonald W AndersonAssistant Secretary Enrollment · (425) 358-9786
Enumeration DateFebruary 21, 2013
Last NPPES UpdateJuly 1, 2025
NPPES CertifiedJuly 1, 2025
✔ NPI 1790025104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
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 Heart Clinic East At Ppmc

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 1790025104. It was assigned to this organization in the NPPES registry on February 21, 2013. The provider is doing business as Providence Medical Group and Providence Heart Clinic East at PPMC.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 4805 NE Glisan St Suite 1g08, Portland, OR 97213. The listed phone number is (503) 962-1000.

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

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

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.