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NPI · 1104097906 · NPPES-sourced

Providence Health & Services Oregon

ActivePediatrics
NPI Number
1104097906
Type 2 · Organisation
Taxonomy Code
208000000X
Contact
(360) 577-1771
Primary practice line
Last Updated
About 11 months ago (Jun 2025)
Enumerated 2008-03-19
Primary practice addressWA · 98632-2503
971 11th AveLongview, WA 98632-2503
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About this NPIWhat this record shows.

NPI 1104097906 is registered to Providence Health & Services Oregon, a healthcare organisation classified as "Pediatrics" and located at 971 11th Ave in Longview, Washington. The organisation's authorised official is Donald Anderson. The organisation has been enumerated in the NPI registry since 2008.

Provider type
Organisation (Type 2)
Status
Active
Enumerated
2008-03-19
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Medicare enrollment

This provider holds a Medicare enrollment on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.

Part B Supplier

Source: CMS PECOS public enrollment file.

Insurance & acceptsHow to confirm coverage.

The National Plan and Provider Enumeration System (NPPES) registry does not include commercial insurance network data, so we cannot show which plans Providence Health & Services Oregon accepts. To confirm in-network status with your specific health plan, contact Providence Health & Services Oregon directly at (360) 577-1771.

Frequently asked

Yes. NPI 1104097906 is registered as Active in the CMS NPPES public registry and passes the Luhn check-digit validation that all 10-digit NPIs use.

Pediatrics is the medical specialty focused on the health of infants, children, and adolescents through age 21.

The CMS NPPES Public Registry at npiregistry.cms.hhs.gov is the authoritative source. FindMyNPI mirrors this dataset and refreshes monthly. For real-time verification, you can also call the provider's office at (360) 577-1771.

An individual healthcare provider has a single Type-1 NPI for life. Organisations can hold separate Type-2 NPIs per location, specialty, or sub-entity. Providence Health & Services Oregon is a Type-2 organisational NPI.

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Quick facts

Provider typeOrganisation
Taxonomy208000000X
Last updated2025-06
Enumerated2008-03-19
StatusActive
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1 record · same addressOther providers at this location.

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Same specialtyOther Pediatrics providers in Washington.

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Adjacent in the NPPES enumeration sequenceNPIs enumerated around this one.

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