Organization · Type 2 NPI

Providence Health & Services - Oregon

Hematology & Oncology Physician · Portland, OR

NPI number 1417136995 Active

Practice location

9135 SW Barnes Rd, Suite 261
Portland, OR 97225-6784

Call (503) 215-6300 Map

Fax (503) 216-6324

Mailing address

PO Box 31001 - 4180
Pasadena, CA 91110-4180

Specialties and licenses

Taxonomy	Code	License
Hematology & Oncology Physician Primary	207RH0003X	None listed
Clinic/Center	261Q00000X	None listed

Hematology & Oncology Physician: An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

56 other providers at this address

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NPI record

NPI: 1417136995
Entity type: Organization (Type 2)
Issued: Oct 31, 2007
Last updated: Jul 4, 2025
Status: Active

Other names

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Providence Medical Group · doing business as
Providence Oncology & Hematology Care Clinic · doing business as

Authorized official

Donald W Anderson
Assistant Secretary Enrollment
(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 1417136995

Providence Health & Services - Oregon's National Provider Identifier is 1417136995, issued on Oct 31, 2007. The primary taxonomy on file is Hematology & Oncology Physician (207RH0003X), and the practice location is in Portland, OR. The record was last updated on Jul 4, 2025.