NPIMap

Organization Active NPI

Providence Health & Services Oregon

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Hood River, WA
National Provider Identifier
1073686689
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
PROVIDENCE HEALTH & SERVICES OREGON
Practice address
1125 May Street
Suite 302
Hood River, WA 97031-1526
Phone
(541) 387-6377
NPI assigned
Nov 15, 2006
Last updated
May 15, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PROVIDENCE HEALTH & SERVICES OREGONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Donald W Anderson Jr.
Title
Assistant Secretary Enrollments
Phone
(425) 358-9786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

1125 May Street
Suite 302
Hood River, WA 97031-1526

Mailing address

PO Box 31001-4199
Pasadena, CA 91110-4199
Phone (503) 215-4323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030203000019 OR Part A Provider - End-Stage Renal Disease Facility (ESRD) 7315856010 Practice locations: Hood River, OR
O20040304001330 OR Part B Supplier - Clinic/Group Practice 7315856010 Receives reassigned benefits from 271 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hood River, OR; Mount Hood Parkdale, OR

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Ray Yasui Dialysis CenterCCN 382310
Overall star rating
2.0 of 5
Ownership
Non-profit
Certified
Jun 24, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Other
Dialysis stations
13

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Part of
Providence Portland Medical Center

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1073686689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-4199",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104199",
            "telephone_number": "503-215-4323",
            "fax_number": "503-215-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 MAY STREET",
            "address_2": "SUITE 302",
            "city": "HOOD RIVER",
            "state": "WA",
            "postal_code": "970311526",
            "telephone_number": "541-387-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES OREGON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE HEALTH & SERVICES OREGON",
        "enumeration_date": "2006-11-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.