Organization · Type 2 NPI

Providence Health & Services - Oregon

Critical Care Medicine (Internal Medicine) Physician · Portland, OR

NPI number 1174918890 Active

Practice location

9205 SW Barnes Rd
Portland, OR 97225-6603

Call (503) 216-3191 Map

Fax (503) 216-3190

Mailing address

PO Box 31001-4199
Pasadena, CA 91110-4199

Specialties and licenses

Taxonomy	Code	License
Critical Care Medicine (Internal Medicine) Physician Primary	207RC0200X	None listed

Critical Care Medicine (Internal Medicine) Physician: An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

485 other providers at this address

NPI record

NPI: 1174918890
Entity type: Organization (Type 2)
Issued: Mar 31, 2015
Last updated: Apr 29, 2025
Status: Active

Other names

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Providence Physicians Intensivists · doing business as
Providence Physicians Intensivists · doing business as

Authorized official

Donald W Anderson
Assistant Secretary Enrollments
(425) 358-9786

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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 1174918890

Providence Health & Services - Oregon's National Provider Identifier is 1174918890, issued on Mar 31, 2015. The primary taxonomy on file is Critical Care Medicine (Internal Medicine) Physician (207RC0200X), and the practice location is in Portland, OR. The record was last updated on Apr 29, 2025.