NPIMap

Organization Active NPI

Providence Health & Services - Oregon

Doing business as Prov St. Vincent Medical Ctr

  • Clinical Pathology Physician
  • Portland, OR
National Provider Identifier
1831641745
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology PhysicianTaxonomy code 207ZC0006X
Legal business name
PROVIDENCE HEALTH & SERVICES - OREGON
Doing business as
Prov St. Vincent Medical Ctr
Practice address
9205 SW Barnes Rd
Portland, OR 97225-6603
Phone
(503) 216-1234
NPI assigned
Oct 26, 2016
Last updated
May 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZC0006X Primary
Body Imaging PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085B0100X

Addresses

Primary practice location

9205 SW Barnes Rd
Portland, OR 97225-6603

Mailing address

PO Box 31001-4199
Pasadena, CA 91110-4199

Other names 1

  • Prov St. Vincent Medical Ctr Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000153 OR Part B Supplier - Clinic/Group Practice 9335057447 Receives reassigned benefits from 790 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

10690 NE Cornell Rd
Ste 314
Hillsboro, OR 97124
Phone (503) 216-9760

4035 Mercantile Dr
Ste 108
Lake Oswego, OR 97035
Phone (503) 216-2788

15640 NW Laidlaw Rd
Ste 201
Portland, OR 97229
Phone (503) 215-6555

15640 NW Laidlaw Rd
Ste 202
Portland, OR 97229
Phone (503) 764-0170

417 SW 117th Ave
Ste 210
Portland, OR 97225
Phone (503) 216-7000

5757 S Macadam Ave
Portland, OR 97239
Phone (503) 223-6841

909 SW 18th Ave
Portland, OR 97205
Phone (503) 692-8700

9205 SW Barnes Rd
#2800
Portland, OR 97225
Phone (503) 216-2621

9205 SW Barnes Rd
#5E
Portland, OR 97225
Phone (503) 216-2028

9205 SW Barnes Rd
Ste 20
Portland, OR 97225
Phone (503) 216-2229

9340 SW Barnes Rd
Portland, OR 97225
Phone (503) 215-6628

9340 SW Barnes Rd
Ste 200
Portland, OR 97225
Phone (503) 215-3081

9427 SW Barnes Rd
Fl 1
Portland, OR 97225
Phone (503) 216-7255

9427 SW Barnes Rd
Ste 196
Portland, OR 97225
Phone (503) 216-7255

9427 SW Barnes Rd
Ste 197
Portland, OR 97225
Phone (503) 216-1250

9427 SW Barnes Rd
Ste 295
Portland, OR 97225
Phone (503) 216-3299

9450 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-2025

9450 SW Barnes Rd
#125
Portland, OR 97225
Phone (503) 216-4646

12442 SW Scholls Ferry Rd
Ste 202
Tigard, OR 97223
Phone (503) 216-9280

18040 SW Lower Boones Ferry Rd
Ste 102
Tigard, OR 97224
Phone (503) 215-6555

18040 SW Lower Boones Ferry Rd
Ste 200
Tigard, OR 97224
Phone (503) 216-0680

29345 SW Town Center Loop E
Ste 212
Wilsonville, OR 97070
Phone (503) 582-2102

Practitioners & affiliated clinicians

Practitioners 734

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 734

NPI Registry JSON

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1831641745",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 SW BARNES RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256603",
            "telephone_number": "503-216-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES - OREGON",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-26",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "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": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prov St. Vincent Medical Ctr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.