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NPI Verification

National Provider Identifier: 1053419218

Providence Health & Services - Oregon

Organization

Primary Specialty

Family Medicine

Code: 207Q00000X

All Specialties (3)

Internal Medicine, Endocrinology, Diabetes & Metabolism

Code: 207RE0101X

Clinic/Center

Code: 261Q00000X

Family Medicine

Code: 207Q00000X

Primary

Practice Address

440 NW DIVISION ST

GRESHAM, OR 970305506

Phone: 503-215-9500

NPI Enumeration Date

September 20, 2006

NPI Number

1053419218

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry