Organization · Type 2 NPI

Providence Health & Services Oregon

Hematology & Oncology Physician · Portland, OR

NPI number 1801010004 Active

Practice location

4805 NE Glisan St Ste 11N
Portland, OR 97213-2933

Call (503) 215-8650 Map

Fax (503) 215-8653

Mailing address

PO Box 31001 - 4180
Pasadena, CA 91110-4180

Specialties and licenses

TaxonomyCodeLicense
Hematology & Oncology Physician Primary 207RH0003XNone listed
Hepatology Physician 207RI0008XNone listed
Medical Oncology Physician 207RX0202XNone listed
Surgery Physician 208600000XNone listed
Surgical Oncology Physician 2086X0206XNone listed
Clinic/Center 261Q00000XNone 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.

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About NPI 1801010004

Providence Health & Services Oregon's National Provider Identifier is 1801010004, issued on Apr 12, 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.