PROVIDENCE MEDICAL GROUP – Cardiovascular Disease Physician, NPI 1225378615

PROVIDENCE MEDICAL GROUP is a healthcare provider. based in Portland, Oregon. specializing in Cardiovascular Disease Physician. The NPI Number for PROVIDENCE MEDICAL GROUP is 1225378615

Main info

Organization
Name
PROVIDENCE MEDICAL GROUP
NPI
1225378615
Phone
(503) 215-6494
Address
PO BOX 3158
Authorized Official
DONALD WAYNE ANDERSON JR. ASSISTANT SECREATRY FOR ENROLLMENT
Enumeration Date
21 February 2013
Last Update Date
4 July 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness90
Years active:13State licenses:0Digital endpoints

Provider Addresses for PROVIDENCE MEDICAL GROUP

  • PO BOX 3158

    PORTLAND, OR 972083158

    Phone: (503) 215-6494

    Fax: (503) 215-6644

    Type: Mailing

  • PO BOX 31001 - 4180

    PASADENA, CA 911104180

    Phone: (503) 215-6494

    Fax: (503) 215-6644

    Type: Mailing

  • 1003 PROVIDENCE DR

    SUITE 325

    NEWBERG, OR 971327521

    Phone: (503) 216-0770

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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

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Medicare Utilization (FFS)

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

Insurance plans in this area (ZIP 97208)

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Reviews

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Frequently asked questions

What is the registry number for PROVIDENCE MEDICAL GROUP?
The registry entry for PROVIDENCE MEDICAL GROUP shows NPI 1225378615.
Quick check: is PROVIDENCE MEDICAL GROUP active?
Public NPPES data shows PROVIDENCE MEDICAL GROUP with an active NPI status right now.
What type of care does PROVIDENCE MEDICAL GROUP provide?
PROVIDENCE MEDICAL GROUP's profile centers on Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
Is PROVIDENCE MEDICAL GROUP tied to Portland, Oregon?
If you are local to Portland, Oregon, PROVIDENCE MEDICAL GROUP may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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