PROVIDENCE HEALTH & SERVICES OREGON – NPI #1245330380
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

PROVIDENCE HEALTH & SERVICES OREGON is a provider located in CLACKAMAS, OR. NPPES has assigned the NPI number 1245330380 to PROVIDENCE HEALTH & SERVICES OREGON on September 25, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. This provider is also associated with 2 additional names listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was last updated on Jun 20, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PROVIDENCE HEALTH & SERVICES OREGON below.

NPI Profile for
PROVIDENCE HEALTH & SERVICES OREGON

NPI Number
1245330380
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PROVIDENCE HEALTH & SERVICES OREGON
Other name(s)
All associated names:
Doing Business As (dba)
PROVIDENCE MEDICAL GROUP
Doing Business As (dba)
Providence Medical Group Sunnyside
Primary location
9290 SE SUNNYBROOK BLVD
SUITE 120
CLACKAMAS, OR 97015
Phone: (503) 215-2110 Fax: (503) 215-2115
Mailing address
PO BOX 31001 - 4180
PASADENA, CA 91110-4180
Phone: (503) 215-6494 Fax: (503) 215-6644
Organization Subpart
No
Authorized Official
DONALD ANDERSON
ASST CORP SECRETARY FOR ENROLLMENTS
Phone: (425) 358-9786
Updated
Certification Date
Jun 20, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for PROVIDENCE HEALTH & SERVICES OREGON

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDOR043997
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
261Q00000X
- Clinic/Center

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.