| NPI | 1124129903 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-09-26 |
| Last Updated | 2025-06-20 |
| Authorized Official | Donald Anderson Assistant Secretary of Enrollments Phone: 4253589786 |
| Mailing Address | Po Box 31001 - 4180 Pasadena, CA 91110-4180 United States Phone: (503) 215-6446 | Fax: (503) 215-6644 📍 View Map |
| Primary Practice Address | 1321 Ne 99th Ave, Suite 200 Portland, OR 97220-9439 United States Phone: (503) 215-4250 | Fax: (503) 215-4255 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | OR | 022844 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 261Q00000X – Clinic/Center | — | — |
| Yes | 207Q00000X – Family Medicine | — | — |
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About NPI 1124129903
Providence Health & Services - Oregon is an organization registered in the CMS NPPES NPI Registry with NPI number 1124129903. The primary specialty listed is Family Medicine. The organization is located in Portland, OR. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-09-26. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1124129903?
NPI 1124129903 belongs to Providence Health & Services - Oregon, a Family Medicine in Portland, OR. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1124129903 active?
The current status of NPI 1124129903 in the NPPES registry is Active. The record was last updated on 2025-06-20.
What specialty is NPI 1124129903?
NPI 1124129903 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1124129903?
You can verify NPI 1124129903 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1124129903?
The primary practice address on file for NPI 1124129903 is 1321 Ne 99th Ave, Portland, OR 97220-9439. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1124129903 issued?
NPI 1124129903 was first issued (enumerated) on 2006-09-26. The NPPES record was last updated on 2025-06-20.
Practice Location Map
Providence Health & Services - Oregon is located at 1321 Ne 99th Ave, Portland, OR. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Providence Health & Services - Oregon. All records sourced from the CMS NPPES registry.