Providence Health & Services - Oregon
Organization Active NPI Internal Medicine Physician · Hillsboro, OR
NPI 1124458914 · NPPES record last updated Jun 20, 2025
Key facts
- NPI
- 1124458914
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- PROVIDENCE HEALTH & SERVICES - OREGON
- Practice address
- 7305 SE Circuit Dr
Hillsboro, OR 97123-1915 - Phone
- (503) 334-4714
- NPI assigned
- Nov 15, 2013
- Organization subpart
- No
Authorized official
- Name
- Donald W Anderson Jr.
- Title
- Assistant Secretary of Enrollments
- Phone
- (425) 358-9786
Practitioners 66
-
Lola Achilova, P.A.-C
-
Daniel Alexander Ananyev, D.O.
-
Nicole Benthin, NP
-
Andrew David Bodmer, PA-C
-
Joanna M Bove, MD
-
Tarra Lynne Castillo, CNM, NMNP
-
Selin Cronkrite, MPH, MSHS, PA-C
-
Morgan R Cunningham, PA-C
-
Erica C Delgado, MD
-
Mary Ann Dunlap, ANP
-
Dianne C Eardley, MD
-
Colleen Amanda Finnegan, M.D.
-
Jonathan William Gietzen, PA-C
-
Kyle R Hampton, DPT
-
Sarah Taylor Harris, PA-C
-
Anna L Hiebert, FNP
-
Jennifer Higham, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031106000652 | OR | Part B Supplier - Clinic/Group Practice | 0648183608 |
Receives reassigned benefits from 1,658 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
7305 SE Circuit Dr
Hillsboro, OR 97129
Phone (503) 216-8400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | Yes | ||
| Clinic/Center | 261Q00000X |
Addresses
Primary practice location
7305 SE Circuit Dr
Hillsboro, OR 97123-1915
Mailing address
PO Box 31001 - 4180
Pasadena, CA 91110-4180
Other practice location 1
265 SE Oak St
Hillsboro, OR 97123-4392
Phone (503) 216-0850
Other names
- Providence Medical Group
Other providers in Hillsboro, OR
- Progressive Counseling Services Hillsboro
- Teresa Marie Prohaska
- Christopher Tobias Prouty
- Providence Health & Services - Oregon
- Providence Health & Services - Oregon
- Providence Health & Services - Oregon
- Providence Health & Services - Oregon
- Providence Health & Services - Oregon
- Providence Health & Services - Oregon
- Providence Health & Services Oregon
All providers in Hillsboro, OR · Internal Medicine Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.