PROVIDENCE PORTLAND MEDICAL CENTER NPI 1134240021

NPI Information

  • NPI: 1134240021
  • Provider Name: PROVIDENCE PORTLAND MEDICAL CENTER
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Doing Business As: PROVIDENCE HOSPITALISTS EAST
  • Address: 4805 NE GLISAN ST
    SUITE BG05
    PORTLAND, OR
    ZIP 97213
  • Phone: (503) 215-2392

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NPI Details

PROVIDENCE PORTLAND MEDICAL CENTER is a clinic center in Portland, OR. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PROVIDENCE PORTLAND MEDICAL CENTER NPI is 1134240021. The provider is registered as an organization entity type.
The provider Is Doing Business As Providence Hospitalists East.

The provider's business location address is:

4805 NE GLISAN ST
SUITE BG05
PORTLAND, OR
ZIP 97213-933
Phone: (503) 215-2392

The provider's authorized official is William Olson .
The authorized official title is Chief Finance Officer and has the following contact phone number (503) 215-6241.

The enumeration date for this NPI number is 4/2/2007 and was last updated on 10/30/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1286612MEDICAIDOREGON
2111652MEDICARE PINOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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