Organization · Type 2 NPI

Providence Health & Services Oregon

Adult Mental Health Clinic/Center · Portland, OR

NPI number 1093963209 Active

Practice location

5251 NE Glisan St, Bldg A, 2nd Floor
Portland, OR 97213-3052

Call (503) 215-4860 Map

Mailing address

PO Box 31001 - 4180
Pasadena, CA 91110-4180

Specialties and licenses

Taxonomy	Code	License
Psychiatry Physician	2084P0800X	None listed
Child & Adolescent Psychiatry Physician	2084P0804X	None listed
Geriatric Psychiatry Physician	2084P0805X	None listed
Adult Mental Health Clinic/Center Primary	261QM0850X	None listed
Adolescent and Children Mental Health Clinic/Center	261QM0855X	None listed
Psychiatric/Mental Health Nurse Practitioner	363LP0808X	None listed

Adult Mental Health Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

7 other providers at this address

Other adult mental health clinic/center providers in Portland

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NPI record

NPI: 1093963209
Entity type: Organization (Type 2)
Issued: Aug 29, 2008
Last updated: May 26, 2026
Status: Active

Other names

<unavail>
Providence Medical Group · doing business as
Providence Psychiatry East · doing business as

Authorized official

Donald W Anderson
Assistant Secretary of Enrollments
(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 1093963209

Providence Health & Services Oregon's National Provider Identifier is 1093963209, issued on Aug 29, 2008. The primary taxonomy on file is Adult Mental Health Clinic/Center (261QM0850X), and the practice location is in Portland, OR. The record was last updated on May 26, 2026.