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PROVIDENCE HEALTH & SERVICES OREGON
NPI 1922330828
Pharmacy - Community/Retail Pharmacy in Tigard, OR

Active since February 03, 2010
18040 SW LOWER BOONES FERRY RD STE 104, TIGARD, OR 97224(503) 216-0625(503) 216-0630 Get Directions Write a Review

NPPES record last updated: July 8, 2025. Verified against the NPPES registry weekly; last sync: August 16, 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 1922330828), doing business as Providence Bridgeport Pharmacy, is a healthcare organization registered as a community/retail pharmacy in Tigard, Oregon and active in the NPI registry since February 2010. The organization lists Donald Wayne Anderson, Assistant Secreatry For Enrollment, as its authorized official.

NPPES Registry Identity

NPI1922330828
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NamePROVIDENCE HEALTH & SERVICES OREGON
Location Address18040 SW LOWER BOONES FERRY RD STE 104Tigard, OR 97224-7259
Mailing Address18040 Sw Lower Boones Ferry Rd, Suite 104Tigard, OR 97224-7258 · (503) 216-0625 · Fax (503) 216-0630
Phone(503) 216-0625
Fax(503) 216-0630
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAssistant Secreatry For Enrollment · (425) 358-9786
Enumeration DateFebruary 3, 2010
Last NPPES UpdateJuly 8, 2025
NPPES CertifiedJuly 8, 2025
✔ NPI 1922330828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in OR · RP-0002571-CS
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
18040 SW LOWER BOONES FERRY RD STE 104, Tigard, OR 97224
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Other Names 1

Doing Business AsProvidence Bridgeport Pharmacy

Other Identifiers 1

Other3843768Ncpdp Provider Identification Number

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BENJAMIN EUGENE JAQUES PHARM.D, RPH
Pharmacist
18040 SW LOWER BOONES FERRY RD STE 104
TIGARD, OR 97224
Washington County (503) 216-0626

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 1922330828. It was assigned to this organization in the NPPES registry on February 3, 2010. The provider is doing business as Providence Bridgeport Pharmacy.

Where is Providence Health & Services Oregon located?

Providence Health & Services Oregon is located at 18040 SW Lower Boones Ferry Rd Ste 104, Tigard, OR 97224. The listed phone number is (503) 216-0625.

What is Providence Health & Services Oregon's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Providence Health & Services Oregon was last updated on July 8, 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.