NPIMap

Individual provider Active NPI

Ellen Priscilla Saqueton Bautista Yang, MD

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1174744395
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD126320 Issued in OR
Practice address
417 SW 117TH Ave Ste 200
Portland, OR 97225-5924
Phone
(503) 216-2800
NPI assigned
May 2, 2007
Last updated
Jul 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD126320 OR Primary

Addresses

Primary practice location

417 SW 117TH Ave Ste 200
Portland, OR 97225-5924

Mailing address

417 SW 117TH Ave Ste 200
Portland, OR 97225-5924
Phone (503) 216-1800

Other identifiers 1

IdentifierTypeStateIssuer
500614683MedicaidOR

Other names 1

  • Ellen Priscilla Saqueton Bautista Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ebautista118305@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091215000686 OR Practitioner - Family Practice 9436299823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

417 SW 117TH Ave
Portland, OR 97225-5924

9205 SW Barnes Rd
Portland, OR 97225-6603

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 20, 2011 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

1003 N Providence Dr
Ste 210
Newberg, OR 97132
Phone (503) 537-5620

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

417 SW 117th Ave
Ste 200
Portland, OR 97225
Phone (503) 216-1800

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

9205 SW Barnes Rd
Ste 2800
Portland, OR 97225
Phone (503) 216-2621

Interoperability endpoints

  • Direct secure messaging: ebautista118305@oc.providencedirect.org

Organizations & group practices 3

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1174744395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 SW 117TH AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255924",
            "telephone_number": "503-216-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 SW 117TH AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255924",
            "telephone_number": "503-216-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA YANG",
        "first_name": "ELLEN PRISCILLA",
        "middle_name": "SAQUETON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD126320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500614683",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ebautista118305@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "417 SW 117th Ave Ste 200",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972255924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELLEN PRISCILLA",
            "last_name": "BAUTISTA",
            "middle_name": "SAQUETON",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.