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Providence Health & Services Oregon

NPI 1104097906ActiveOrganization· Pediatrics· Longview, WA

Pediatrics in Longview, Washington, registered in NPPES in March 2008, part of Providence Health & Services - Oregon. The authorized official on file is Donald Wayne Anderson, Assistant Secretary Of Enrollments. Enrolled in Medicare as part b supplier - clinic/group practice.

Overview

NPI1104097906
StatusActive
Entity typeOrganization (subpart)
Parent organizationProvidence Health & Services - Oregon
NPI issuedMar 19, 2008
Last updated in NPPESJun 20, 2025
Certified by providerJun 20, 2025

Specialties and licenses

TaxonomyCodeLicenseState
Pediatrics Primary208000000X——
Clinic/Center261Q00000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Part B Supplier - Clinic/Group Practice (WA)

Medicare sources and data years

Other Pediatrics providers in Longview

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