PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1790113405
Nurse Practitioner in Portalnd, OR

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

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

Active since October 16, 2013

4400 NE HALSEY, BLDG 2 3RD FLR, PORTALND, OR 97213(855) 229-6460(503) 216-0710 Get Directions Write a Review

NPPES record last updated: March 25, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 25, 2026, Jul 4, 2025 (2 updates tracked since 2025).

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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 1790113405), doing business as Providence Medical Group South, is a healthcare organization registered as a nurse practitioner in Portalnd, Oregon and active in the NPI registry since October 2013. The organization lists Donald Wayne Anderson, Assistant Secretary Enrollment, as its authorized official.

NPPES Registry Identity

NPI1790113405

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON

Location Address4400 NE HALSEY, BLDG 2 3RD FLRPortalnd, OR 97213

Mailing AddressPo Box 3158Portland, OR 97208-3158

Phone(855) 229-6460

Fax(503) 216-0710

Organization SubpartNo

Authorized OfficialDonald Wayne AndersonAssistant Secretary Enrollment · (425) 358-9786

Enumeration DateOctober 16, 2013

Last NPPES UpdateMarch 25, 20262 updates tracked since enumeration

NPPES CertifiedMarch 25, 2026

✔ NPI 1790113405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.

Also ListedClinic/CenterTaxonomy 261Q00000X

4400 NE HALSEY, Portalnd, OR 97213

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Other Names 2

Doing Business AsProvidence Medical Group South

Doing Business AsProvidence Health Express Bp

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 1790113405. It was assigned to this organization in the NPPES registry on October 16, 2013. The provider is doing business as Providence Medical Group South and Providence Health eXpress BP.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 4400 NE Halsey Bldg 2 3rd Flr, Portalnd, OR 97213. The listed phone number is (855) 229-6460.

What is Providence Health & Services - Oregon'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 Health & Services - Oregon was last updated on March 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.