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
| NPI | 1104097906 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Providence Health & Services - Oregon |
| NPI issued | Mar 19, 2008 |
| Last updated in NPPES | Jun 20, 2025 |
| Certified by provider | Jun 20, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Primary | 208000000X | — | — |
| Clinic/Center | 261Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (WA) |
|---|
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