PROVIDENCE HEALTH & SERVICES - OREGON


Address: 18040 Sw Lower Boones Ferry Rd, Suite 204, Tigard, OR 97224-7259
Phone: 5032160770

PROVIDENCE HEALTH & SERVICES - OREGON (NPI# 1720402472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720402472
Entity Type Organization
Organization Name PROVIDENCE HEALTH & SERVICES - OREGON
Other Organization Name PROVIDENCE ST VINCENT CARDIAC DEVICE AND MONITORING CLINIC BRIDGEPORT
Practice Address 18040 Sw Lower Boones Ferry Rd
Suite 204
Tigard
OR 97224-7259
Mailing Address Po Box 3158
Portland
OR 97208-3158
Practice Telephone 5032160770
Practice Fax Number 5032160775
Enumeration Date 2014-02-14
Last Update Date 2014-02-14
Authorized Official Name KEENAN B FREEMAN (CFO)
Authorized Official Telephone 5035936524
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
Allopathic & Osteopathic Physicians
Y 261Q00000X Clinic/Center Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Providence St Vincent Cardiac Device and Monitoring Clinic Bridgeport Doing Business As Name - Organization

Other Provider IDs and Locations

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

Other Data Sources

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

Office Location

Street Address 18040 SW LOWER BOONES FERRY RD
SUITE 204
City TIGARD
State OR
Zip Code 97224-7259

Providers in the same location

NPI Name Taxonomy Address Enumeration
1952384430 Pamela A. Devisser Nurse Practitioner 18040 Sw Lower Boones Ferry Rd, Suite 100, Tigard, OR 97224-7258 2005-11-29
1689211740 Gabrielle Johnson Specialist/Technologist 18040 Sw Lower Boones Ferry Rd, Tigard, OR 97224-7258 2019-12-06
1326588708 Susan Kathleen Glinka Psychologist 18040 Sw Lower Boones Ferry Rd, Suite 304, Tigard, OR 97224-7258 2017-03-03
1689097131 Providence Health & Services - Oregon Internal Medicine 18040 Sw Lower Boones Ferry Rd, Suite 204, Tigard, OR 97224-7259 2014-02-03
1790113405 Providence Health & Services - Oregon Clinic/Center 18040 Sw Lower Boones Ferry Rd, Suite 100, Tigard, OR 97224-7259 2013-10-16
1669726345 Deborah Ann Jones Physical Therapist 18040 Sw Lower Boones Ferry Rd, Tigard, OR 97224-7258 2012-11-02
1568749539 Heather Leann Adair Physician Assistant 18040 Sw Lower Boones Ferry Rd, Suite 100, Tigard, OR 97224-7258 2011-11-04
1568756591 Michael D Goodwin Family Medicine 18040 Sw Lower Boones Ferry Rd, Ste 100, Tigard, OR 97224-7258 2011-06-07
1245549724 Providence Health & Services Oregon Clinic/Center 18040 Sw Lower Boones Ferry Rd, Suite 207, Tigard, OR 97224-7259 2010-09-30
1275842957 Lisa Rose Lundin Pharmacist 18040 Sw Lower Boones Ferry Rd, Tigard, OR 97224-7258 2010-09-29
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1154973139 Katherine Raineri Psychologist 7213 Sw Hazel Fern Rd, Tigard, OR 97224 2019-07-10
1871064618 Stacey A Wenzel Speech-Language Pathologist 17020 Sw Upper Boones Ferry Rd.,suite 201, Tigard, OR 97224 2018-12-05
1376010090 Meredith Rae Brezinski Physical Therapist 18019 Sw Boones Ferry Road, Tigard, OR 97224 2018-10-31
1649759358 Viktoriya A Chiliy Behavior Technician 15290 Sw Royalty Parkway, Tigard, OR 97224 2018-08-13
1609384866 Rachel E King Physical Therapist 18040 Sw Lower Boones Ferry Rd Ste 200, Tigard, OR 97224 2018-01-22
1689190134 Isabelle Cooper Klee Caballero Speech-Language Pathologist 17020 Sw Upper Boones Ferry Road Suite 201, Tigard, OR 97224 2017-08-16
1427573146 Breanna M Sandefur Behavior Technician 15290 Sw Royalty Pkwy, Tigard, OR 97224 2017-08-03
1083141196 Krista Espenship Registered Nurse 8032 Sw Ashford St, Tigard, OR 97224 2017-05-19
1275067928 Emily Elizabeth Myers Behavioral Analyst 15290 Royalty Parkway, Tigard, OR 97224 2017-04-19
1235684937 Melanie Salvador Nurse Practitioner 15352 Sw Oakmont Pl, Tigard, OR 97224 2016-08-23
Find all providers in zip 97224

Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

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).

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1336704071 Integrated Joint Specialists LLC Clinic/Center 10250 Sw Greenburg Rd Ste 115, Tigard, OR 97223-5461 2019-05-08
1457819971 Advanced Acupuncture & Oriental Medicine, LLC Clinic/Center 9735 Sw Shady Ln Ste 306, Tigard, OR 97223-5481 2019-03-04
1780199679 Ideal Option, Pllc Clinic/Center 9735 Sw Shady Ln Ste 103, Tigard, OR 97223-5481 2017-12-13
1790113405 Providence Health & Services - Oregon Clinic/Center 18040 Sw Lower Boones Ferry Rd, Suite 100, Tigard, OR 97224-7259 2013-10-16
1568715019 Metis Clinics Clinic/Center 7110 Sw Fir Loop, Suite 210, Tigard, OR 97223-8084 2012-10-22
1053670117 Tigard Holistic Health Clinic, LLC Clinic/Center 11930 Sw Greenburg Rd, Tigard, OR 97223-6453 2012-05-10
1245549724 Providence Health & Services Oregon Clinic/Center 18040 Sw Lower Boones Ferry Rd, Suite 207, Tigard, OR 97224-7259 2010-09-30
1588981963 Providence Health & Services - Oregon Clinic/Center 18040 Sw Lower Boones Ferry Rd, Suite 204, Tigard, OR 97224-7259 2010-04-26
1821224957 Providence Health & Services Oregon Clinic/Center 18040 Sw Lower Boones Ferry Rd, Suite 100, Tigard, OR 97224 2009-06-03
1770723017 Providence Health & Services - Oregon Clinic/Center 18040 Sw Lower Boones Ferry Rd, Suite 100, Tigard, OR 97224-7215 2009-02-26
Find all providers in TIGARD

Competitor

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City TIGARD
Zip Code 97224

Improve Information

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Dataset Information

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.

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