NPIMap

Organization Active NPI

Providence Health & Services - Oregon

  • Durable Medical Equipment & Medical Supplies
  • Lacey, WA
National Provider Identifier
1285201798
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PROVIDENCE HEALTH & SERVICES - OREGON
Practice address
8605 Commerce Place Dr NE Ste a
Lacey, WA 98516-3813
Phone
(503) 215-4333
NPI assigned
Jun 4, 2021
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 Wayne Anderson Jr.
Title
Assistant Secretary of Enrollments
Phone
(425) 358-9786

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Oxygen Equipment & Supplies (DME) 332BX2000X

Addresses

Primary practice location

8605 Commerce Place Dr NE Ste a
Lacey, WA 98516-3813

Mailing address

PO Box 5936a
Portland, OR 97228-5936
Phone (503) 215-4663

Other names 2

  • PROV HEALTH SYS-OR SHARED-SVS DIV Doing business as
  • PROVIDENCE HOME MEDICAL EQUIPMENT Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wilson Medical Group18 organizations share this tax ID, including this one
Part of
Wilson Medical Group

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

8605 Commerce Place Dr NE
#A
Lacey, WA 98516
Phone (503) 215-4333

3311 S 120th Pl
Tukwila, WA 98168

NPI Registry JSON

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1285201798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5936A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972285936",
            "telephone_number": "503-215-4663",
            "fax_number": "503-215-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8605 COMMERCE PLACE DR NE STE A",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985163813",
            "telephone_number": "503-215-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES - OREGON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE HEALTH & SERVICES - OREGON",
        "enumeration_date": "2021-06-04",
        "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": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROV HEALTH SYS-OR SHARED-SVS DIV",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PROVIDENCE HOME MEDICAL EQUIPMENT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PROVIDENCE HOME MEDICAL EQUIPMENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lacey, WA

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.