Active NPI
Claire McCord Conrad, MD
- Pediatrics Physician
- Portland, OR
National Provider Identifier
1023694866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD61523170
- Practice address
- 3181 SW Sam Jackson Park Rd # L-579
Portland, OR 97239-3098 - Phone
- (503) 494-8211
- NPI assigned
- Mar 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD61523170 | WA | Primary |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd # L-579
Portland, OR 97239-3098
Mailing address
9675 SE 36TH St Ste 100
Mercer Island, WA 98040-3723
Phone (206) 275-2122
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD61523170 | WA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718841600000",
"number": "1023694866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9675 SE 36TH ST STE 100",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "980403723",
"telephone_number": "206-275-2122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD # L-579",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393098",
"telephone_number": "503-494-8211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONRAD",
"first_name": "CLAIRE",
"middle_name": "MCCORD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-22",
"last_updated": "2024-06-20",
"certification_date": "2024-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD61523170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.