Organization · Type 2 NPI

Providence Health & Services - Oregon

Hematology (Internal Medicine) Physician · Milwaukie, OR

NPI number 1053727636 Active

Practice location

3300 SE Dwyer Dr, Suite 304
Milwaukie, OR 97222-6548

Call (503) 513-8043 Map

Mailing address

PO Box 31001 - 4180
Pasadena, CA 91110-4180

Specialties and licenses

Taxonomy	Code	License
Hematology (Internal Medicine) Physician Primary	207RH0000X	None listed
Clinic/Center	261Q00000X	None listed

Hematology (Internal Medicine) Physician: An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia and lymphoma.

6 other providers at this address

NPI record

NPI: 1053727636
Entity type: Organization (Type 2)
Issued: Jul 3, 2014
Last updated: Jun 20, 2025
Status: Active

Other names

<unavail>
Providence Medical Group · doing business as
Providence Medical Group Anticoagulation Telephone Management · doing business as
Providence Medical Group Anticoagulation Telephone Management · doing business as

Authorized official

Donald Wayne Anderson
Assistant Secretary Enrollment
(425) 358-9786

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1053727636

Providence Health & Services - Oregon's National Provider Identifier is 1053727636, issued on Jul 3, 2014. The primary taxonomy on file is Hematology (Internal Medicine) Physician (207RH0000X), and the practice location is in Milwaukie, OR. The record was last updated on Jun 20, 2025.