PROVIDENCE HEALTH & SERVICES-OREGON (NPI# 1124343215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124343215 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES-OREGON |
| Other Organization Name | PROVIDENCE CHILD CENTER |
| Practice Address |
830 Ne 47th Ave Attn: Dental Clinic Portland OR 97213-2212 |
| Mailing Address |
830 Ne 47th Ave Attn: Finance Portland OR 97213-2212 |
| Practice Telephone | 5032152400 |
| Practice Fax Number | 5032150660 |
| Mailing Telephone | 5032152400 |
| Mailing Fax Number | 5032150660 |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2010-03-31 |
| Authorized Official Name | PATRICIA JEAN BUDO (OPERATIONS ADMINISTRATOR) |
| Authorized Official Telephone | 5032152413 |
| Authorized Official Credential | LCSW, NHA, JD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Providence Child Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962844241 | Providence Health & Services-oregon | Hospice Care, Community Based | 580 S Main St, Mount Angel, OR 97362-9540 | 2013-07-26 |
| 1811384423 | Providence Health & Services-oregon | Case Management | 4900 Ne Glisan St, Portland, OR 97213-2936 | 2015-04-21 |
| 1073896551 | Providence Health & Services-oregon | Radiologic Technologist | 315 Se Stone Mill Dr, Suite 102, Vancouver, WA 98684-6998 | 2011-09-21 |
| 1205119781 | Providence Health & Services-oregon | Radiologic Technologist | 101 Nw 12th Ave, Suite 107, Battle Ground, WA 98604-9141 | 2011-09-21 |
| 1558689653 | Providence Health & Services-oregon | Clinic/Center | 830 Ne 47th Ave, Attn: Finance, Portland, OR 97213-2212 | 2010-05-13 |
| 1376625137 | Providence Health & Services-oregon | Skilled Nursing Facility | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2006-10-20 |
| Street Address |
830 NE 47TH AVE ATTN: DENTAL CLINIC |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213-2212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053408005 | Peter John Lax | Dentist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2006-10-09 |
| 1225521404 | Lydia Eve Jahn | Physical Therapist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2018-06-12 |
| 1669970521 | Gabriela Barajas Quiroz | Peer Specialist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2018-01-25 |
| 1053829663 | Carol Lipson Criswell | Peer Specialist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2018-01-17 |
| 1649788241 | Diane Cervi | Peer Specialist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2018-01-17 |
| 1740793579 | Katie Lynn Harris | Peer Specialist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2017-11-15 |
| 1629597935 | Paige Wollenzien | Dietitian, Registered | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2017-09-18 |
| 1831631753 | Darrick Stiff | Speech-Language Pathologist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2016-11-09 |
| 1871042044 | Rebecca Spencer | Speech-Language Pathologist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2016-09-28 |
| 1508313842 | Amy Grimm | Physical Therapist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2016-09-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
| 1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
| 1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
| 1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
| 1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
| 1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
| 1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
| Find all providers in zip 97213 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003430711 | Md Portland LLC | Clinic/Center | 15 Middle St # A-c2, Portland, ME 04101-4881 | 2020-05-29 |
| 1598396350 | Roots Dental, Pllc | Clinic/Center | 191 Marginal Way Ste C, Portland, ME 04101-3387 | 2020-01-30 |
| 1063065068 | Portland Dental Smiles | Clinic/Center | 732 Sw 3rd Ave Ste 202, Portland, OR 97204-2409 | 2019-07-18 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1063993749 | Roots Dental Stark LLC | Clinic/Center | 16338 Se Stark St, Portland, OR 97233-3958 | 2018-08-22 |
| 1528546330 | Christopher Brady Dmd LLC | Clinic/Center | 4707 Ne 102nd Ave Ste A, Portland, OR 97220-3393 | 2018-08-02 |
| 1124511191 | Enk Dental PC | Clinic/Center | 6516 Ne Siskiyou St, Portland, OR 97213-4572 | 2018-06-13 |
| 1760997654 | Gary S Hongo Dmd, LLC | Clinic/Center | 9732 Se Washington St Ste H, Portland, OR 97216-8405 | 2017-12-13 |
| 1689183717 | Kai-uwe H. Hahn Dmd Dba Edelweiss Dental | Clinic/Center | 3503 N Lombard Street, Portland, OR 97217 | 2017-09-20 |
| 1962930362 | Alaniz Family & Cosmetic Dentistry, PC | Clinic/Center | 11701 Se Stark St, Portland, OR 97216-3759 | 2017-05-30 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.