PROVIDENCE HEALTH & SERVICES OREGON
NPI 1801010004
Internal Medicine - Hematology & Oncology in Portland, OR

Q: What is Providence Health & Services Oregon's NPI number?

The NPI number for Providence Health & Services Oregon is 1801010004. It was assigned to this organization in the NPPES registry on April 12, 2007. The provider is doing business as Providence Liver Cancer Clinic and Providence Medical Group.

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

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Active since April 12, 2007

4805 NE GLISAN ST STE 11N, PORTLAND, OR 97213(503) 215-8650(503) 215-8653 Get Directions Write a Review

NPPES record last updated: July 4, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 4, 2025, Jul 19, 2019 (2 updates tracked since 2019).

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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 1801010004), doing business as Providence Liver Cancer Clinic, is a healthcare organization registered as a hematology & oncology in Portland, Oregon and active in the NPI registry since April 2007. The organization lists Donald Wayne Anderson, Asst Secretary For Enrollments, as its authorized official.

NPPES Registry Identity

NPI1801010004

Entity TypeOrganization

Primary Taxonomy207RH0003X

Legal Business NamePROVIDENCE HEALTH & SERVICES OREGON

Location Address4805 NE GLISAN ST STE 11NPortland, OR 97213-2933

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

Phone(503) 215-8650

Fax(503) 215-8653

Organization SubpartNo

Authorized OfficialDonald Wayne AndersonAsst Secretary For Enrollments · (425) 358-9786

Enumeration DateApril 12, 2007

Last NPPES UpdateJuly 4, 20252 updates tracked since enumeration

NPPES CertifiedJuly 4, 2025

✔ NPI 1801010004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

Also ListedInternal Medicine · HepatologyTaxonomy 207RI0008X

Also ListedInternal Medicine · Medical OncologyTaxonomy 207RX0202X

Also ListedSurgeryTaxonomy 208600000X

Also ListedSurgery · Surgical OncologyTaxonomy 2086X0206X

Also ListedClinic/CenterTaxonomy 261Q00000X

4805 NE GLISAN ST STE 11N, Portland, OR 97213

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Other Names 2

Doing Business AsProvidence Liver Cancer Clinic

Doing Business AsProvidence Medical Group

Other Identifiers 1

Medicaid274461OR

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

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 1,048 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 1801010004. It was assigned to this organization in the NPPES registry on April 12, 2007. The provider is doing business as Providence Liver Cancer Clinic and Providence Medical Group.

Where is Providence Health & Services Oregon located?

Providence Health & Services Oregon is located at 4805 NE Glisan St Ste 11N, Portland, OR 97213. The listed phone number is (503) 215-8650.

What is Providence Health & Services Oregon's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

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 1,048 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Providence Health & Services Oregon accept?

Health plans from Providence Health Plan list Providence Health & Services Oregon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Providence Health & Services Oregon was last updated on July 4, 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.