Organization · Type 2 NPI

Providence Health & Services Oregon

Rural Health Clinic/Center · Cannon Beach, OR

NPI number 1841756764 Active

Practice location

171 N Larch St Ste 16
Cannon Beach, OR 97110-3103

Call (503) 717-7400 Map

Mailing address

PO Box 31001-4199
Pasadena, CA 91110-4199

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Multi-Specialty Clinic/Center	261QM1300X	None listed
Rural Health Clinic/Center Primary	261QR1300X	None listed

Rural Health Clinic/Center: Definition to come...

Another provider at this address

Christopher Lewis Craft, FNP-BCFamily Nurse Practitioner Cannon Beach, OR NPI 1598723918

NPI record

NPI: 1841756764
Entity type: Organization (Type 2)
Issued: Feb 15, 2019
Last updated: Apr 29, 2025
Status: Active

Other names

<unavail>
Providence Seaside Hospital - Providence Cannon Beach Clinic · doing business as
Providence Seaside Hospital, Providence Cannon Beach Clinic · doing business as
Providence Seaside Hospital, Providence Cannon Beach Clinic · doing business as

Authorized official

Donald W Anderson
Assistant Secretary 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 1841756764

Providence Health & Services Oregon's National Provider Identifier is 1841756764, issued on Feb 15, 2019. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Cannon Beach, OR. The record was last updated on Apr 29, 2025.