Providence Elder Place Portland – Multi-Specialty Clinic/Center, NPI 1023098118

Providence Elder Place Portland is a healthcare provider. based in Portland, Oregon. specializing in Multi-Specialty Clinic/Center. The NPI Number for Providence Elder Place Portland is 1023098118

Main info

Organization
Name
Providence Elder Place Portland
NPI
1023098118
Phone
(503) 215-6556
Address
13007 NE GLISAN ST
Authorized Official
MR. DONALD W ANDERSON JR. ASSISTANT SECRETARY OF ENROLLMENT
Enumeration Date
17 January 2006
Last Update Date
16 May 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness80
Years active:20State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Providence Elder Place Portland

  • Providence Elderplace Glendoveer, 13007, Northeast Glisan Street, Hazelwood, Portland, Metro, Multnomah County, Oregon, 97230, United States

    PORTLAND, OR 972302545

    Phone: (503) 215-6556

    Fax: (503) 215-0685

    Type: Mailing

  • 4540, Northeast Glisan Street, North Tabor, Portland, Metro, Multnomah County, Oregon, 97213, United States

    PORTLAND, OR 972132333

    Phone: (503) 215-3738

    Fax: (503) 215-6942

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97230)

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Reviews

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Frequently asked questions

What NPI should I save for Providence Elder Place Portland?
Save NPI 1023098118 if you need a stable reference for Providence Elder Place Portland.
Is Providence Elder Place Portland's NPI currently valid?
The extract we use shows Providence Elder Place Portland as active.
What kind of provider is Providence Elder Place Portland?
The page reflects Multi-Specialty Clinic/Center for Providence Elder Place Portland. Clinical services aligned with this taxonomy classification.
What location metadata exists for Providence Elder Place Portland?
The page summarizes Portland, Oregon for Providence Elder Place Portland; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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