Organization · Type 2 NPI

Providence Health & Services - Oregon

Family Medicine Physician · Battle Ground, WA

NPI number 1194013144 Active

Practice location

101 NW 12th Ave, Suite 107
Battle Ground, WA 98604-9141

Call (360) 666-4480 Map

Fax (360) 666-4485

Mailing address

PO Box 31001-4180
Pasadena, CA 91110-4180

Other practice locations

3101 SE 192nd Ave Ste 103, Vancouver, WA 98683-1443 · (360) 666-4480

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed
Internal Medicine Physician	207R00000X	None listed
Physician Assistant	363A00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

13 other providers at this address

Other family medicine physician providers in Battle Ground

See all in Battle Ground →

NPI record

NPI: 1194013144
Entity type: Organization (Type 2)
Issued: Jul 12, 2011
Last updated: Jun 20, 2025
Status: Active

Other names

<unavail>
Providence Medical Group · doing business as
Providence Medical Group Battle Ground Family Medicine · doing business as

Authorized official

Donald Wayne 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 1194013144

Providence Health & Services - Oregon's National Provider Identifier is 1194013144, issued on Jul 12, 2011. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Battle Ground, WA. The record was last updated on Jun 20, 2025.