Active NPI
Providence Health & Services - Oregon
Doing business as Providence Rehab Services-Camas
- Physical Therapist
- Vancouver, WA
National Provider Identifier
1104109677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- PROVIDENCE HEALTH & SERVICES - OREGON
- Doing business as
- Providence Rehab Services-Camas
- Practice address
- 3101 SE 192ND Ave
Suite 104
Vancouver, WA 98683-1442 - Phone
- (360) 553-7480
- Fax
- (360) 553-7485
- NPI assigned
- Sep 21, 2011
- Last updated
- May 14, 2025
- Organization subpart
- Yes
- Parent organization
- PROVIDENCE HEALTH & SERVICES - OREGON
NPPES NPI Registry
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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | WA | Primary | |
| Occupational Therapist | 225X00000X | WA | ||
| Speech-Language Pathologist | 235Z00000X | WI |
Addresses
Primary practice location
3101 SE 192ND Ave
Suite 104
Vancouver, WA 98683-1442
Mailing address
PO Box 3395
Portland, OR 97208-3395
Phone (503) 215-4323
Other names 1
- Providence Rehab Services-Camas
National Provider Directory
National Provider Directory- Part of
- Providence Hood River Memorial Hospital Pharmacy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316563200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1747180800000",
"number": "1104109677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3395",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083395",
"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": "3101 SE 192ND AVE",
"address_2": "SUITE 104",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986831442",
"telephone_number": "360-553-7480",
"fax_number": "360-553-7485"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROVIDENCE HEALTH & SERVICES - OREGON",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PROVIDENCE HEALTH & SERVICES - OREGON",
"enumeration_date": "2011-09-21",
"last_updated": "2025-05-14",
"certification_date": "2025-05-14",
"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": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Providence Rehab Services-Camas",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Providence Rehab Services-Camas",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Vancouver, WA
- Michelle G Prostler, LMT
- Taylor Proudfit, LMT
- David Alan Proujan, R.PH
- Jennifer M Prouse, RD
- Janetta C Proverbs, M.D.
- Providence Health & Services - Oregon (Providence Medical Group)
- Providence Health & Services - Oregon (Providence St Vincent Heart Clinic Cardiology Mill Plain)
- Providence Health & Services - Oregon (Providence Medical Group Esther Short)
- Providence Health & Services - Oregon (Providence Medical Group)
- Providence Health & Services - Oregon (Providence Medical Group Mill Plain XRAY)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.