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PROVIDENCE PORTLAND CANCER CENTER
NPI 1790168797
General Acute Care Hospital in Portland, OR

Active since July 08, 2015
4805 NE GLISAN ST, SUITE 6N60, PORTLAND, OR 97213(503) 215-3258 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Providence Portland Cancer Center NPPES

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

PROVIDENCE PORTLAND CANCER CENTER (NPI 1790168797) is a healthcare organization registered as a general acute care hospital in Portland, Oregon and active in the NPI registry since July 2015. The organization lists Donald W Anderson, Assistant Secretary Enrollments, as its authorized official.

NPPES Registry Identity

NPI1790168797
Entity TypeOrganization
Primary Taxonomy282N00000X
Legal Business NamePROVIDENCE PORTLAND CANCER CENTER
Location Address4805 NE GLISAN ST, SUITE 6N60Portland, OR 97213-2933
Mailing Address4805 Ne Glisan St, Suite 6n60Portland, OR 97213-2933 · (503) 215-3258
Phone(503) 215-3258
Organization SubpartNo
Authorized OfficialDonald W AndersonAssistant Secretary Enrollments · (425) 358-9786
Enumeration DateJuly 8, 2015
Last NPPES UpdateMay 7, 2025
NPPES CertifiedMay 7, 2025
✔ NPI 1790168797 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral Acute Care HospitalHospitals
Taxonomy Code282N00000X
License✔ Licensed in OR · FE172129
Definition

An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.

4805 NE GLISAN ST, Portland, OR 97213
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 38D0682992

Providence Portland Medical Center Poct Laboratory · Portland, OR
Expired · Dec 31, 2025
CLIA Number38D0682992
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateJanuary 1, 2024
Certificate Expiration DateDecember 31, 2025
Laboratory DirectorDouglas P. Blackall
Laboratory Phone(503) 215-3806
Laboratory LocationProvidence Portland Medical Center Poct Laboratory4805 NE Glisan, Portland, OR 97213
CLIA data matches this NPI record on: Address
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

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.

DR. CHRISTOPHER MICHAEL BARONE
Internal Medicine
4805 NE GLISAN ST, SUITE BG05
PORTLAND, OR 97213
Multnomah County (503) 215-2392
TODD SHANE CROCENZI M.D.
Internal Medicine (Medical Oncology)
4805 NE GLISAN ST, 6N40
PORTLAND, OR 97213
Multnomah County (503) 215-5696
SHARON D KENNEDY NP
Registered Nurse (General Practice)
4805 NE GLISAN ST, 3E
PORTLAND, OR 97213
Multnomah County (503) 215-6494
REBECCA E CHANDLER MD
Internal Medicine
4805 NE GLISAN ST, SUITE BG05
PORTLAND, OR 97213
Multnomah County (503) 215-2392
MICHAEL J CLAYTON MD
Internal Medicine
4805 NE GLISAN ST, SUITE BG05
PORTLAND, OR 97213
Multnomah County (503) 215-2392
JAMES STUART MORGAN MD
Internal Medicine
4805 NE GLISAN ST, BG05
PORTLAND, OR 97213
Multnomah County (503) 215-2392
NANCY A PHILLIPS MD
Psychiatry & Neurology (Psychiatry)
4805 NE GLISAN ST, 5L
PORTLAND, OR 97213
Multnomah County (503) 215-7669
VICKI COLLISTER ANP
Registered Nurse
4805 NE GLISAN ST
PORTLAND, OR 97213
Multnomah County (503) 215-4620

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 Portland Cancer Center's NPI number?

The NPI number for Providence Portland Cancer Center is 1790168797. It was assigned to this organization in the NPPES registry on July 8, 2015.

Where is Providence Portland Cancer Center located?

Providence Portland Cancer Center is located at 4805 NE Glisan St Suite 6n60, Portland, OR 97213. The listed phone number is (503) 215-3258.

What is Providence Portland Cancer Center's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital with taxonomy code 282N00000X.

When was this NPI record last updated?

The NPPES record for Providence Portland Cancer Center was last updated on May 7, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.