Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Providence Health & Services - Oregon

Organization Physical Therapist · NPI 1104109677

Providence Health & Services - Oregon provides Physical Therapist services in Vancouver, Washington. Licensed in Washington and Wisconsin. Registered with an NPI since 2011.

Licensed in
WA, WI
In the registry since
2011
Specialties on file
3
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Practice location Address checks out

3101 SE 192nd Ave Ste 104
Vancouver, WA 98683-1442
Phone: (360) 553-7480
Fax: (360) 553-7485
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X (WA)
Occupational Therapist Taxonomy 225X00000X (WA)
Speech-Language Pathologist Taxonomy 235Z00000X (WI)

Record details

NPI number1104109677
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Health & Services - Oregon
Authorized official Donald Anderson — Assistant Secretary Enrollments · (425) 358-9786
Other names Providence Rehab Services-Camas; Providence Rehab Services-Camas
NPI enumeratedSeptember 21, 2011
Last updated in NPPESMay 14, 2025
Certification dateMay 14, 2025
Mailing addressPo Box 3395, Portland, OR 97208-3395

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