NPIMap

Organization Active NPI

Providence Health & Services Oregon

Doing business as Providence Hood River Memorial Hospital

  • Critical Access Hospital
  • Hood River, OR
National Provider Identifier
1255429338
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
PROVIDENCE HEALTH & SERVICES OREGON
Doing business as
Providence Hood River Memorial Hospital
Practice address
810 12TH St
Hood River, OR 97031-1587
Phone
(503) 451-3000
Fax
(503) 215-0290
NPI assigned
Oct 11, 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
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

810 12TH St
Hood River, OR 97031-1587

Mailing address

PO Box 31001-4199
Pasadena, CA 91110-4199
Phone (503) 451-3000

Other identifiers 10

IdentifierTypeStateIssuer
3300415OtherORWASHINGTON MEDICAID
CH9950OtherORRAILROAD MEDICARE
210241MedicaidOR
5411OtherORWA DEPT OF LABOR CLINIC
804295000OtherORREGENCE CLINIC NUMBER
330045000001OtherORPROVIDENCE HEALTH PLAN
5982OtherORWA DEPT OF LABOR HOSPITAL
138000604OtherORREGENCE HOSPITAL NUMBER
195086600OtherORUS DEPT OF LABOR WC
227600OtherORMEDICAID CLINIC OUTPT

Other names 1

  • Providence Hood River Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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
O20061104000324 OR Part A Provider - Critical Access Hospital 7315856010 Receives reassigned benefits from 140 practitioners
Practice locations: Hood River, OR; Mount Hood Parkdale, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255429338. Details of each certification follow.

Hospital certification: CCN 381318

Legal name
PROVIDENCE HEALTH & SERVICES OREGON
Doing business as
PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Apr 30, 2004
Last certification
Oct 15, 2015
Beds
32 (25 certified)
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Feb 20, 1934 in OR
Enrollment address
810 12TH St
Hood River, OR 97031-1587
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

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: Hospital

Medicare Care Compare
Listed as
Providence Hood River Memorial HospitalCCN 381318 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Providence Portland Medical Center

Ownership & related parties

All disclosed owners & managing parties 26

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Diane L Hejna Individual Corporate DirectorBoard Member Jul 1, 2016
Richard S Blair Individual Corporate DirectorBoard Member Jul 1, 2016
Providence Health & Services-Oregon Organization, Portland, OR Corporation 5% Or Greater Direct Ownership Interest May 18, 2010
Marvin O'Quinn Individual Corporate DirectorBoard Member Jan 1, 2024
Jeanette Vieira Individual W-2 Managing EmployeeChief Executive, HR SVC Area Jun 15, 2016
Linda Buck Individual Corporate DirectorBoard Member Jan 1, 2025
Providence Health & Services - Washington Organization, Renton, WA Non-profit Operational/Managerial Control May 18, 2010
Mary E Lyons Individual Corporate DirectorBoard Member Jul 1, 2016
Phyllis M Hughes Individual Corporate DirectorDirector Jan 1, 2014
Rogelio Riojas Individual Corporate DirectorBoard Member Jan 1, 2025
James Martin Individual Corporate Officer Jan 13, 2023
Casey E Parker Individual W-2 Managing EmployeeFinance Executive Jan 1, 2025
Charles Wallace Sorenson Individual Corporate DirectorBoard Member Jan 1, 2019
Donald Wayne Anderson Individual Corporate OfficerAssistant Secretary of Enrollment Jan 1, 2017
Gregory David Hoffman Individual Corporate OfficerEvp/Cfe Oct 1, 2020
Isiaah D Crawford Individual Corporate DirectorDirector Feb 1, 2012
Melissa Ann Damm Individual W-2 Managing EmployeeOregon Cfo Feb 18, 2019
Donna Markham Individual Corporate DirectorBoard Member Jan 1, 2024
Michael W Murphy Individual Corporate DirectorBoard Member Jan 1, 2020
Providence Health & Services Organization, Renton, WA Non-profit Other Jul 1, 2016
Mary Beth Kingston Individual Corporate Director Sep 1, 2022
Eric D Sprunk Individual Corporate Director Jan 1, 2022
Anna R Newsom Individual Corporate Officer May 13, 2022
Darryl Elmouchi Individual Corporate OfficerPresident/Ceo Apr 1, 2025
Karin Dufault Individual Corporate DirectorBoard Member Jan 1, 2025
Providence St. Joseph Health Organization, Renton, WA Non-profit Other Jul 1, 2016

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 139

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 139

Practitioners & affiliated clinicians

Practitioners 204

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 204

Affiliated clinicians 277

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

View all 277

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1255429338",
    "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": "503-451-3000",
            "fax_number": "503-215-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 12TH ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311587",
            "telephone_number": "503-451-3000",
            "fax_number": "503-215-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES OREGON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE HEALTH & SERVICES  OREGON",
        "enumeration_date": "2006-10-11",
        "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": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON MEDICAID",
            "identifier": "3300415",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH9950",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210241",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DEPT OF LABOR CLINIC",
            "identifier": "5411",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE CLINIC NUMBER",
            "identifier": "804295000",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDENCE HEALTH PLAN",
            "identifier": "330045000001",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DEPT OF LABOR HOSPITAL",
            "identifier": "5982",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE HOSPITAL NUMBER",
            "identifier": "138000604",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR WC",
            "identifier": "195086600",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CLINIC OUTPT",
            "identifier": "227600",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Hood River Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Hood River Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hood River, OR

Sources for this page

Verify at the official NPI Registry.