PROVIDENCE SEASIDE HOSPITAL - PROVIDENCE WARRENTON CLINIC – Rural Health Clinic/Center, NPI 1972039170
Rural Health Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for PROVIDENCE SEASIDE HOSPITAL - PROVIDENCE WARRENTON CLINIC
113 S HIGHWAY 101
WARRENTON, OR 971469314
Phone: (503) 861-6500
Type: Location
171 S HIGHWAY 101
WARRENTON, OR 97146
Phone: (503) 717-7000
Type: Location
171 S Highway 101
Warrenton, OR 971469314
Phone: (503) 861-6500
Type: Location
300 Block Southwest Lincoln, Southwest Lincoln Street, University District, Portland Downtown, Portland, Metro, Multnomah County, Oregon, 97258, United States
PORTLAND, OR 972083397
Phone: (503) 893-7120
Fax: (425) 276-3215
Type: Mailing
PO BOX 31001-4199
PASADENA, CA 911104199
Phone: (503) 893-7120
Fax: (425) 276-3215
Type: Mailing
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.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-07-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20170706001783 | O | Rural Health Clinic | OR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
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 97146)
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