Providence Health & Services - Oregon
Providence Health & Services - Oregon is a healthcare organization registered as Family Medicine Physician in Gresham, OR, holding Type 2 (organization) NPI 1053419218 since 2006. The authorized official on file is Donald Anderson, Asst Sec Enroll.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1053419218 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Providence Health & Services - Oregon |
| Other name | <Unavail> |
| Practice address | 440 NW DIVISION ST, Gresham, OR, 97030 |
| Phone | 5032159500 |
| Fax | 5032159525 |
| Enumeration date | 2006-09-20 |
| Last updated in NPPES | 2025-06-20 |
Authorized official
| Name | Donald Anderson |
|---|---|
| Title | Asst Sec Enroll |
| Phone | 4253589786 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | Secondary | — | — |
| 261Q00000X | Clinic/Center | Secondary | — | — |
| 207Q00000X | Family Medicine Physician | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 287333 | Medicaid | OR | — |
Copy-ready billing details
Provider: Providence Health & Services - Oregon NPI: 1053419218 Taxonomy: 207Q00000X (Family Medicine Physician) Address: 440 NW DIVISION ST, Gresham, OR, 97030
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1700872785 | Steven Maness | Individual | Internal Medicine Physician | Gresham, OR |
| 1730133679 | Sunita Deshmukh | Individual | Internal Medicine Physician | Gresham, OR |
| 1346288123 | Robert Bailey | Individual | Internal Medicine Physician | Gresham, OR |
| 1700824505 | Jon Hobson | Individual | Family Medicine Physician | Gresham, OR |
| 1578509980 | Kevin Carpenter | Individual | Family Medicine Physician | Gresham, OR |
| 1689605776 | Janet Patin | Individual | Family Medicine Physician | Gresham, OR |
| 1225113236 | Richard Knowles | Individual | Family Medicine Physician | Gresham, OR |
| 1447323878 | Carmela Pajarillo | Individual | Family Medicine Physician | Gresham, OR |
Verify this record
Cross-check NPI 1053419218 against the authoritative CMS record: view Providence Health & Services - Oregon on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Providence Health & Services - Oregon located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-06-20.