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

Providence Portland Medical Center

Organization Nurse Practitioner · NPI 1316199987

Providence Portland Medical Center provides Nurse Practitioner services in Portland, Oregon. Registered with an NPI since 2008.

In the registry since
2008

Practice location Address checks out

4805 NE Glisan St
Portland, OR 97213-2933
Phone: (503) 215-6185
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1316199987
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Enrollments · (425) 358-9786
Other names Prov Nurse Practitioners East
NPI enumeratedOctober 15, 2008
Last updated in NPPESMay 7, 2025
Certification dateMay 7, 2025
Mailing addressPo Box 3158, Portland, OR 97208-3158

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