NPI 1376625137

Providence Health & Services-Oregon

Organisation Nursing Facility/Intermediate Care Facility Portland, OR

Practice location

Address: 830 NE 47th Ave, Portland, OR 97213-2212
Phone: (503) 215-2400
Fax: (503) 215-0660
Mailing address: 830 NE 47th Ave Attn: Finance, Portland, OR 97213-2212

Authorised official

Name: Donald W Anderson
Title: Assistant Secretary for Enrollments
Phone: (425) 358-9786

Registered specialties (3)

Nursing Facility/Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 313M00000X Licence 1700250565 (OR)

Other Nursing Facility/Intermediate Care Facility providers in Oregon →

Pediatric Skilled Nursing Facility

Nursing & Custodial Care Facilities Taxonomy 3140N1450X Licence 1035453259 (OR)

Other Skilled Nursing Facility providers in Oregon →

Child Physical Disabilities Respite Care

Respite Care Facility Taxonomy 385HR2065X Licence 1035453259 (OR)

Other Respite Care providers in Oregon →

Registry record

NPI: 1376625137
Entity type: Organization
NPI issued: 20 Oct 2006
Record last updated: 15 May 2025

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.