Lisa Diane Watts, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO21895 Issued in OR

Practice address

1027 E Burnside St
Portland, OR 97214-1328

Phone

(503) 239-8400

NPI assigned

Aug 10, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coda, Inc.

  • Substance Abuse Rehabilitation Facility
  • Portland, OR
  • NPI 1437213865
  NPD
• Coda, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Seaside, OR
  • NPI 1750912184
  NPD
• Recovery Works NW LLC

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1871264416
  NPD
• Legacy Clinics LLC

  • Rural Health Clinic/Center
  • Sandy, OR
  • NPI 1730472192
  NPD (past)
• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  Family Medicine

  NPD (past)
• Oak Grove Family Medical Clinic P C

  • Family Medicine Physician
  • Milwaukie, OR
  • NPI 1346218369
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1023029725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141328",
            "telephone_number": "503-239-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141328",
            "telephone_number": "503-239-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 SE Washington St",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971234230",
            "country_code": "US",
            "telephone_number": "503-648-0753",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11970 SW Greenburg Rd",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972236453",
            "country_code": "US",
            "telephone_number": "503-624-8304",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10822 SE 82nd Ave",
            "address_purpose": "LOCATION",
            "city": "Happy Valley",
            "state": "OR",
            "postal_code": "970867658",
            "country_code": "US",
            "telephone_number": "503-654-7444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATTS",
        "first_name": "LISA",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO21895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Dena Watters, DC
• Jenny D. Watters, L.C.S.W.
• Sean Tyler Watters, M.D.
• Seth David Watterson, D.C.
• Kendyl Watts, LCSW
• Paul Waude
• Nicholas B Wavers, PCA
• Zoey Elise Wavrin-Olson, DO
• Mark Kenneth Wax, MD
• Andrew Austin Way

• Family Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.