NPI 1013217975

Providence Health & Services - Oregon

Organisation Obstetrics & Gynecology Physician Portland, OR

Practice location

Address: 4805 NE Glisan St STE 11n, Portland, OR 97213-2933
Phone: (503) 215-2075
Fax: (503) 215-2077
Mailing address: PO Box 31001-4180, Pasadena, CA 91110-4180

Authorised official

Name: Donald Wayne Anderson
Title: Assistant Secretary Enrollment
Phone: (425) 358-9786

Registered specialties (2)

Obstetrics & Gynecology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207V00000X

Other Obstetrics & Gynecology providers in Oregon →

Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261Q00000X

Other Clinic/Center providers in Oregon →

Registry record

NPI: 1013217975
Entity type: Organization
NPI issued: 26 Oct 2010
Record last updated: 25 Mar 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.