Organization · Type 2 NPI

Providence Health & Services - Oregon

Surgery Physician · Newberg, OR

NPI number 1629146121 Active

Practice location

310 Villa Rd, Suite 104
Newberg, OR 97132-1886

Call (503) 537-1508 Map

Mailing address

PO Box 31001 - 4180
Pasadena, CA 91110-4180

Specialties and licenses

Taxonomy	Code	License
Otolaryngology Physician	207Y00000X	None listed
Surgery Physician Primary	208600000X	None listed

Surgery Physician: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasin…

4 other providers at this address

NPI record

NPI: 1629146121
Entity type: Organization (Type 2)
Issued: Dec 1, 2006
Last updated: Jul 4, 2025
Status: Active
Subpart: Yes of Providence Health & Services - Oregon

Other names

<unavail>
PMG Newberg Surgical Services · doing business as
Providence Medical Group · doing business as

Authorized official

Donald Wayne Anderson
Assistant Secreatry for Enrollment
(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 1629146121

Providence Health & Services - Oregon's National Provider Identifier is 1629146121, issued on Dec 1, 2006. The primary taxonomy on file is Surgery Physician (208600000X), and the practice location is in Newberg, OR. The record was last updated on Jul 4, 2025.