PROVIDENCE HEALTH & SERVICES - OREGON (NPI# 1174918890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174918890 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - OREGON |
| Other Organization Name | PROVIDENCE PHYSICIANS INTENSIVISTS |
| Practice Address |
9205 Sw Barnes Rd Portland OR 97225-6603 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5032163191 |
| Practice Fax Number | 5032163190 |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2020-06-19 |
| Authorized Official Name | DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY FOR ENROLLMENT/) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Physicians Intensivists | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922481456 | Providence Health & Services - Oregon | Psychiatry & Neurology | 10830 Highway 62, Eagle Point, OR 97524-9516 | 2015-07-01 |
| 1023440435 | Providence Health & Services - Oregon | General Acute Care Hospital | 11445 Se Moon Dust Ct, Happy Valley, OR 97086-8033 | 2013-08-08 |
| 1568793313 | Providence Health & Services - Oregon | Clinic/Center | 17550 Provost St Ste 201, Lake Oswego, OR 97034-5199 | 2010-01-19 |
| 1508015348 | Providence Health & Services - Oregon | Clinic/Center | 16180 Se Sunnyside Road, Suite 102, Happy Valley, OR 97015-6302 | 2008-09-17 |
| 1114085545 | Providence Health & Services - Oregon | Internal Medicine | 1314 E Sherman St, Newberg, OR 97132-1842 | 2006-12-05 |
| 1629146121 | Providence Health & Services - Oregon | Otolaryngology | 310 Villa Rd, Suite 104, Newberg, OR 97132-1886 | 2006-12-01 |
| 1992882500 | Providence Health & Services - Oregon | Clinic/Center | 205 N Phoenix Rd, Suite A, Phoenix, OR 97535-9104 | 2006-11-01 |
| 1013018175 | Providence Health & Services - Oregon | Clinic/Center | 510 Bridge St, Vernonia, OR 97064-1218 | 2006-09-25 |
| 1447799523 | Providence Health & Services - Oregon | Clinic/Center | 1698 E Mcandrews Rd Ste 170, Medford, OR 97504-5590 | 2017-02-22 |
| 1063963106 | Providence Health & Services - Oregon | Clinic/Center | 1698 E Mcandrews Rd, Ste 300, Medford, OR 97504-5589 | 2016-10-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Oregon | 1801 Lind Avenue, Sw, Renton, WA 98057-9016 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| System for Award Management (SAM) Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 4400 Ne Halsey St Bldg 2 Ste 690, Portland, OR 97213-1545 |
| Iowa Business Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave. Sw, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw # 9016, Renton, WA 98057 |
| Street Address |
9205 SW BARNES RD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-6603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326041526 | Nate D Quilici | Specialist | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2005-05-23 |
| 1487251773 | Leah Burke Chapman | Nurse Practitioner | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-10-08 |
| 1366054819 | Jennifer Haas Pierron | Registered Nurse | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-08-17 |
| 1831717974 | Steffany Bixby | Dietitian, Registered | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-07-06 |
| 1477174076 | Nathaniel Edwards | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-05 |
| 1801417407 | Karissa Kunihira | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-05 |
| 1720609324 | Jakob Feeney | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-05 |
| 1710508320 | Banu Ramachandran | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-05 |
| 1083235964 | Amy Pohodich | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-01 |
| 1740801620 | Steven C Freeman | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548587660 | Anna Kristin Brady | Internal Medicine | 3181 Sw Sam Jackson Park Rd # 67, Portland, OR 97239-3011 | 2010-04-29 |
| 1699869255 | Ralph A Juarez | Internal Medicine | 10201 Se Main St Ste 11, Portland, OR 97216-2937 | 2006-10-03 |
| 1285731059 | Catherine J Markin | Internal Medicine | 2222 Nw Lovejoy St., Mob 1 Suite 411, Portland, OR 97210 | 2006-09-20 |
| 1477520120 | Poh Hock Leng | Internal Medicine | 2222 Nw Lovejoy St Ste 411, Portland, OR 97210-5102 | 2006-03-01 |
| 1184034399 | Matthew Miller | Internal Medicine | 3181 Sw Sam Jackson Park Rd # Uhn67, Portland, OR 97239-3079 | 2014-04-28 |
| 1497098602 | Tony Adams | Internal Medicine | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2013-04-05 |
| 1598054132 | Peter Jackson | Internal Medicine | 2222 Nw Lovejoy St, #411, Portland, OR 97210-3033 | 2011-04-05 |
| 1497910210 | Lianne Liang-jung Lin | Internal Medicine | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6652 | 2008-07-21 |
| 1720264476 | Hataya Kristy Poonyagariyagorn | Internal Medicine | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6667 | 2008-01-11 |
| 1942406178 | Kathryn Amelia Artis | Internal Medicine | 3181 Sw Sam Jackson Park Rd, Mail Code Bte 119, Portland, OR 97239-3011 | 2007-06-25 |
| 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.