Organization · Type 2 NPI

Providence Health & Services Oregon

Cardiovascular Disease Physician · Portland, OR

NPI number 1114244597 Active

Practice location

9427 SW Barnes Rd, Ste 495
Portland, OR 97225-6652

Call (503) 216-0900 Map

Mailing address

PO Box 31001-4180
Pasadena, CA 91110-4180

Specialties and licenses

TaxonomyCodeLicense
Cardiovascular Disease Physician Primary 207RC0000XNone listed
Clinic/Center 261Q00000XNone listed
Physician Assistant 363A00000XNone listed
Medical Physician Assistant 363AM0700XNone listed
Nurse Practitioner 363L00000XNone listed
Family Nurse Practitioner 363LF0000XNone listed

Cardiovascular Disease Physician: An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

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About NPI 1114244597

Providence Health & Services Oregon's National Provider Identifier is 1114244597, issued on Apr 26, 2010. The primary taxonomy on file is Cardiovascular Disease Physician (207RC0000X), and the practice location is in Portland, OR. The record was last updated on Jun 20, 2025.