PROVIDENCE HEALTH & SERVICES - OREGON (NPI# 1366536963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366536963 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - OREGON |
| Other Organization Name | PROVIDENCE MILWAUKIE HOSPITAL |
| Practice Address |
10150 Se 32nd Ave Milwaukie OR 97222-6516 |
| Mailing Address |
Po Box 3397 Portland OR 97208-3397 |
| Practice Telephone | 5036528300 |
| Mailing Telephone | 5032154323 |
| Mailing Fax Number | 5032150297 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-07-06 |
| Authorized Official Name | DR. DONALD W ANDERSON JR. (ASST SEC FOR ENROLL/DIR REIMB ADMIN) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH & SERVICES - OREGON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207U00000X | Nuclear Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians | ||
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | WASHINGTON MEDICAID | 3003373 | 01 |
| WA | WA DEPT. OF LABOR | 95916 | 01 |
| OR | RAILROAD MEDICARE | C45062 | 01 |
| OR | US DEPT. OF LABOR WC | 194589600 | 01 |
| OR | REGENCE HOSPITAL NUMBER | 138008200 | 01 |
| OR | 175620 | 05 | |
| OR | PROVIDENCE HEALTH PLAN | 050100000001 | 01 |
| Other Name | Type Code |
|---|---|
| Providence Milwaukie Hospital | 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 |
10150 SE 32ND AVE |
| City | MILWAUKIE |
| State | OR |
| Zip Code | 97222-6516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700485737 | Stephani Sue Jirikovic | Pharmacist | 10150 Se 32nd Ave, Milwaukie, OR 97222-6516 | 2020-10-21 |
| 1801423876 | Judy Marie Schumacker | Social Worker | 10150 Se 32nd Ave, Milwaukie, OR 97222-6516 | 2020-03-26 |
| 1457908840 | Dana Thuy Nguyen | Pharmacist | 10150 Se 32nd Ave, Milwaukie, OR 97222-6516 | 2019-08-21 |
| 1689152860 | Kevin Morikawa | Physical Therapist | 10150 Se 32nd Ave, Milwaukie, OR 97222-6516 | 2018-07-31 |
| 1578014239 | Providence Health & Services Oregon | Anesthesiology | 10150 Se 32nd Ave, Milwaukie, OR 97222-6516 | 2016-10-18 |
| 1356793152 | Brian Schapansky | Nurse Anesthetist, Certified Registered | 10150 Se 32nd Ave, Milwaukie, OR 97222-6516 | 2016-07-06 |
| 1659751360 | Providence Health & Services Oregon | Psychiatric Unit | 10150 Se 32nd Ave, Milwaukie, OR 97222-6516 | 2015-06-08 |
| 1851783138 | Holly Turner | Dietitian, Registered | 10150 Se 32nd Ave, Milwaukie, OR 97222-6516 | 2015-02-24 |
| 1427458231 | Sue F Lee | Nurse Anesthetist, Certified Registered | 10150 Se 32nd Ave, Milwaukie, OR 97222-6516 | 2014-08-28 |
| 1831501394 | Julia Watts Schafer | Nurse Anesthetist, Certified Registered | 10150 Se 32nd Ave, Milwaukie, OR 97222-6516 | 2014-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831731397 | Madalyn Kelly Yowell | Technician | 7809 Southeast Southgate Street, Milwaukee, OR 97222 | 2019-10-16 |
| 1336617448 | Nadia Yang | Social Worker | 2115 Se Adams St, Milwaukie, OR 97222 | 2018-11-06 |
| 1851892368 | Arrow Dental LLC | Dentist | 10505 Se 17th Avenue, Milwaukie, OR 97222 | 2018-02-21 |
| 1851814016 | Cathy Maria Andrew | Acupuncturist | 11022 Se Stanley Ave, Milwaukie, OR 97222 | 2017-07-19 |
| 1972025369 | Sarah Elizabeth Giles | Peer Specialist | 11097 Se 21st Ave., Milwaukie, OR 97222 | 2017-07-07 |
| 1366976292 | Brittany Reubendale | Physical Therapist | 12705 See River Rd, Portland, OR 97222 | 2017-04-18 |
| 1669916383 | Margie Hertz | Registered Nurse | 6406 Se Cedarcrest Drive, Milwaukie, OR 97222 | 2016-12-14 |
| 1952858094 | Alexis Escobar | Speech-Language Pathologist | 4560 Se International Way, Ste 100, Milwaukie, OR 97222 | 2016-09-07 |
| 1205295466 | Beth Ann Mills | Acupuncturist | 2025 Se Jefferson St Ste 106, Milwaukie, OR 97222 | 2016-02-16 |
| 1558744086 | Kyle Eugene Coan | Specialist | 3306 Se Wister St, Milwaukie, OR 97222 | 2015-07-01 |
| Find all providers in zip 97222 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447665526 | Linda Damaskos | General Acute Care Hospital | 310 Nw Upyown Terrace, 2a, Portland, OR 97210 | 2014-06-26 |
| 1003246174 | Rebecca Changizian | General Acute Care Hospital | 2929 Ne 25th Ave, Portland, OR 97212-3460 | 2013-11-26 |
| 1023440435 | Providence Health & Services - Oregon | General Acute Care Hospital | 11445 Se Moon Dust Ct, Happy Valley, OR 97086-8033 | 2013-08-08 |
| 1235483199 | Kaiser Sunnyside Medical Center | General Acute Care Hospital | 3480 Mock Orange Ct S, Salem, OR 97302-3647 | 2012-10-30 |
| 1891048807 | Kaiser Foundation Hospitals | General Acute Care Hospital | 2875 Nw Stucki Ave., Hillsboro, OR 97124-5806 | 2012-10-16 |
| 1710241922 | Silverton Hospital | General Acute Care Hospital | 700 Sw Lupine Ct, Sublimity, OR 97385-9509 | 2012-07-02 |
| 1215213756 | Northwest Association of Surgical Assistants, Inc. | General Acute Care Hospital | 3782 Po Box, Springfield, OR 97475 | 2011-10-28 |
| 1194024760 | Lisa Marie Arbuckle | General Acute Care Hospital | 16105 Sw 108th Ave, Apt. 212, Tigard, OR 97224-4870 | 2011-03-22 |
| 1679879662 | Veterans Hospital | General Acute Care Hospital | 3710 S.w. U.S. Veterans Road, Portland, OR 97239-2964 | 2011-02-08 |
| 1083866933 | Providence St Vincent Hospital | General Acute Care Hospital | 1235 Ne 47th Ave, Suite 285, Portland, OR 97213-2100 | 2008-10-22 |
| Find all providers with the same taxonomy | ||||
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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.