Organization · Type 2 NPI

Providence Health & Services - Oregon

Cardiovascular Disease Physician · Portland, OR

NPI number 1578854857 Active

Practice location

4400 NE Halsey St Ste 102
Portland, OR 97213-1545

Call (503) 962-1000 Map

Mailing address

PO Box 31001 - 4180
Pasadena, CA 91110-4180

Other practice locations

1111 NE 99th Ave, Suite 201, Portland, OR 97220-9442 · (503) 962-1000

Specialties and licenses

Taxonomy	Code	License
Cardiovascular Disease Physician Primary	207RC0000X	None listed
Clinic/Center	261Q00000X	None listed
Multi-Specialty Clinic/Center	261QM1300X	None 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.

31 other providers at this address

Other cardiovascular disease physician providers in Portland

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NPI record

NPI: 1578854857
Entity type: Organization (Type 2)
Issued: Apr 21, 2011
Last updated: Mar 23, 2026
Status: Active

Other names

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Providence Medical Group · doing business as
Providence Heart Clinic Hollywood · doing business as
Providence Heart Clinic at the Oregon Clinic Gateway · doing business as
Providence Heart Clinic at the Oregon Clinic Gateway · doing business as

Authorized official

Mr. 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 1578854857

Providence Health & Services - Oregon's National Provider Identifier is 1578854857, issued on Apr 21, 2011. The primary taxonomy on file is Cardiovascular Disease Physician (207RC0000X), and the practice location is in Portland, OR. The record was last updated on Mar 23, 2026.