Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum Organization subpart

Providence Health & Services Oregon

Family Medicine Physician in Medford, OR · enumerated 2006 · authorized official Donald Anderson, Assistant Secretary Enrollment.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1568547503

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Registry record

Entity type Organization (Type 2)

Legal business name Providence Health & Services Oregon

Other name <Unavail>

Parent organization Providence Health & Services Oregon

Practice address 965 Ellendale Dr, Medford, OR, 97504

Phone (541) 732-6000

Fax (541) 732-6005

Enumeration date Oct 26, 2006

Last updated in NPPES Nov 19, 2025

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Primary

207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians Secondary

2084P0804X Child & Adolescent Psychiatry Physician Allopathic & Osteopathic Physicians Secondary

2084P0805X Geriatric Psychiatry Physician Allopathic & Osteopathic Physicians Secondary

261Q00000X Clinic/Center Ambulatory Health Care Facilities Secondary

261QM0855X Adolescent and Children Mental Health Clinic/Center Ambulatory Health Care Facilities Secondary

Authorized official

Name Donald Anderson

Title Assistant Secretary Enrollment

Phone (425) 358-9786

Other identifiers

Identifier	Type	State	Issuer
288515	Medicaid	OR	-
CG6801	Other	OR	RAILROAD MEDICARE

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 → Validate an NPI →

Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2025-11-19. Verify at npiregistry.cms.hhs.gov.

Where is Providence Health & Services Oregon located?

The practice location on file with NPPES is in Medford, OR.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-11-19.