Organization · Type 2 NPI

Providence Health & Services - Oregon

Cardiovascular Disease Physician · Portland, OR

NPI number 1912290610 Active

Practice location

9427 SW Barnes Rd, Ste 495
Portland, OR 97225-6652

Call (503) 216-1182 Map

Mailing address

PO Box 31001 - 4180
Pasadena, CA 91110-4180

Specialties and licenses

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

125 other providers at this address

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NPI record

NPI: 1912290610
Entity type: Organization (Type 2)
Issued: May 27, 2011
Last updated: Jul 4, 2025
Status: Active

Other names

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Providence Medical Group · doing business as
Providence Center for Advanced Heart Disease · doing business as

Authorized official

Donald Wayne 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 1912290610

Providence Health & Services - Oregon's National Provider Identifier is 1912290610, issued on May 27, 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 Jul 4, 2025.