PROVIDENCE HEALTH & SERVICES OREGON (NPI# 1245330380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245330380 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES OREGON |
| Other Organization Name | PROVIDENCE MEDICAL GROUP SUNNYSIDE |
| Practice Address |
9290 Se Sunnybrook Blvd Suite 120 Clackamas OR 97015 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5032152110 |
| Practice Fax Number | 5032152115 |
| Mailing Telephone | 5032156494 |
| Mailing Fax Number | 5032156644 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2018-07-09 |
| Authorized Official Name | DONALD WAYNE ANDERSON (ASST CORP SECRETARY FOR ENROLLMENTS) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 043997 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Medical Group Sunnyside | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518425693 | Providence Health & Services Oregon | Durable Medical Equipment & Medical Supplies | 2296 Nw Kings Blvd Ste 101, Corvallis, OR 97330-3871 | 2019-03-07 |
| 1841756764 | Providence Health & Services Oregon | Family Medicine | 171 N Larch St Ste 16, Cannon Beach, OR 97110-3103 | 2019-02-15 |
| 1346751443 | Providence Health & Services Oregon | General Practice | 4400 Ne Halsey St, Pop 2, 3rd Floor, Portland, OR 97213-1545 | 2017-10-16 |
| 1922453943 | Providence Health & Services Oregon | Assisted Living Facility | 1550 Brookside Dr, Hood River, OR 97031-8553 | 2016-04-27 |
| 1649541020 | Providence Health & Services Oregon | Clinic/Center | 211 Ne Skyline Dr, White Salmon, WA 98672 | 2012-01-18 |
| 1922330828 | Providence Health & Services Oregon | Pharmacy | 18040 Sw Lower Boones Ferry Rd Ste 104, Tigard, OR 97224-7259 | 2010-02-03 |
| 1801010004 | Providence Health & Services Oregon | Internal Medicine | 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 | 2007-04-12 |
| 1487746491 | Providence Health & Services Oregon | Home Health | 2033 Commerce Dr, Medford, OR 97504-9744 | 2006-09-28 |
| 1831196302 | Providence Health & Services Oregon | Home Health | 570 S Main Street, Mount Angel, OR 97362-9540 | 2005-06-30 |
| 1003319724 | Providence Health & Services Oregon | Clinic/Center | 5211 Ne Glisan St Bldg C, Portland, OR 97213-3052 | 2018-03-09 |
| Street Address |
9290 SE SUNNYBROOK BLVD SUITE 120 |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639163447 | Randall D Gore | Internal Medicine | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6899 | 2005-09-07 |
| 1134660558 | Kelcey Chilcott | Nurse Practitioner | 9290 Se Sunnybrook Blvd, 200, Clackamas, OR 97015-6899 | 2017-03-17 |
| 1922451103 | Mackenna Marie Simpson | Physician Assistant | 9290 Se Sunnybrook Blvd, #120, Clackamas, OR 97015-6899 | 2016-07-22 |
| 1669844809 | Mary Steers | Psychologist | 9290 Se Sunnybrook Blvd, Ste 120, Clackamas, OR 97015-6899 | 2015-10-27 |
| 1952771008 | Danielle Marie Hastings | Nurse Practitioner | 9290 Se Sunnybrook Blvd, #200, Clackamas, OR 97015-6899 | 2015-10-01 |
| 1225422165 | Olivia Marie Gordon | Counselor | 9290 Se Sunnybrook Blvd, Suite 200, Clackamas, OR 97015-6899 | 2015-03-27 |
| 1053716621 | Michelle Shepherd Combs | Psychologist | 9290 Se Sunnybrook Blvd, Clackamas, OR 97015-6899 | 2014-10-24 |
| 1609298967 | Providence Health & Services - Oregon | Clinic/Center | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 | 2014-01-06 |
| 1790107050 | Providence Health & Services - Oregon | Clinic/Center | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 | 2014-01-06 |
| 1730529629 | Jennifer Joan Beemer | Nurse Practitioner | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 | 2013-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265094528 | Evexia, LLC | Clinic/Center | 9123 Se Saint Helens St Ste 100a, Clackamas, OR 97015-6800 | 2019-07-07 |
| 1609298967 | Providence Health & Services - Oregon | Clinic/Center | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 | 2014-01-06 |
| 1790107050 | Providence Health & Services - Oregon | Clinic/Center | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 | 2014-01-06 |
| 1730330119 | New Health Chiropractic PC | Clinic/Center | 15480 Se 82nd Dr, Clackamas, OR 97015-9633 | 2008-10-03 |
| 1689836108 | Providence Health & Services - Oregon | Clinic/Center | 9280 Se Sunnybrook Blvd, Suite 200, Clackamas, OR 97015-6776 | 2008-06-26 |
| 1992978118 | Columbia Clinical Laboratory, Inc | Clinic/Center | 15630 Se 90 Ave., Clackamas, OR 97015-9729 | 2008-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932715935 | J.w. Smith, D.c., LLC | Clinic/Center | 4747 S 6th St Ste 2, Klamath Falls, OR 97603-4993 | 2020-09-16 |
| 1427662204 | Edmund H. Torkelson Do, PC | Clinic/Center | 1960 Nw 167th Pl Ste 204, Beaverton, OR 97006-4804 | 2020-08-31 |
| 1134746589 | Redmond Veterinary Clinic PC | Clinic/Center | 1785 Nw 6th St, Redmond, OR 97756-1204 | 2020-07-01 |
| 1801413240 | Gfm LLC | Clinic/Center | 1235 Se Division St Ste 114, Portland, OR 97202-1042 | 2020-07-01 |
| 1184240277 | Evans & Company Healthcare PC | Clinic/Center | 2330 Morada Ln, Ashland, OR 97520-3641 | 2020-06-24 |
| 1427674324 | Northwest Pain Institute | Clinic/Center | 2005 Cedar St, Forest Grove, OR 97116-1701 | 2020-06-17 |
| 1275168759 | Metatron Health LLC | Clinic/Center | 6464 Sw Borland Rd Ste C3, Tualatin, OR 97062-8856 | 2020-03-05 |
| 1427680057 | Ortc, LLC | Clinic/Center | 750 Biddle Rd Ste 102, Medford, OR 97504-6178 | 2020-02-11 |
| 1134750037 | Legacy Good Samaritan Hospital and Medical Center | Clinic/Center | 1040 Nw 22nd Ave Ste 250, Portland, OR 97210-3057 | 2020-01-29 |
| 1861038382 | Clackamas County | Clinic/Center | 2051 Kaen Rd Ste 210, Oregon City, OR 97045-4035 | 2019-11-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PROVIDENCE HEALTH & SERVICES OREGON.
| 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.