Active NPI
Kathleen Alison Dunham, M.D.
- Surgical Oncology Physician
- Tigard, OR
National Provider Identifier
1194040139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Oncology Physician
- License
- MD173822
- Practice address
- 12123 SW 69TH Ave
Tigard, OR 97223-8514 - Phone
- (971) 708-7600
- Fax
- (971) 371-5230
- NPI assigned
- Apr 1, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Oncology Physician | 2086X0206X | MD173822 | OR | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
12123 SW 69TH Ave
Tigard, OR 97223-8514
Mailing address
1498 SE Tech Center PL
Suite 240
Vancouver, WA 98683-9591
Phone (360) 597-1300
Other practice location 1
265 N Broadway
Portland, OR 97227-1800
Phone (503) 280-1223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12123 SW 69TH Ave
Tigard, OR 97223-8514
Phone (971) 708-7600
210 SE 136TH Ave
Vancouver, WA 98684-6930
Phone (360) 944-9889
265 N Broadway
Portland, OR 97227-1800
Phone (503) 280-1223
Hospital & facility affiliations
- Providence St Vincent Medical Center
- Providence Portland Medical Center
- Legacy Meridian Park Medical Center
- Legacy Good Samaritan Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 34 |
| Melanoma (skin cancer) excision | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- kathleen.dunham@compass.ikm.direct-ci.com
- kdunham154426@direct.ohsu.edu
Organizations & group practices 1
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.
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Clinic/Center
- Portland, OR
- NPI 1679597108
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1780608216
-
- General Acute Care Hospital
- Tualatin, OR
- NPI 1184647620
-
- General Acute Care Hospital
- Portland, OR
- NPI 1003991845
-
- General Acute Care Hospital
- Portland, OR
- NPI 1114015971
-
- Case Manager/Care Coordinator
- Portland, OR
- NPI 1891822995
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715817600000",
"number": "1194040139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1498 SE TECH CENTER PL",
"address_2": "SUITE 240",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986839591",
"telephone_number": "360-597-1300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12123 SW 69TH AVE",
"city": "TIGARD",
"state": "OR",
"postal_code": "972238514",
"telephone_number": "971-708-7600",
"fax_number": "971-371-5230"
}
],
"practiceLocations": [
{
"address_1": "265 N Broadway",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972271800",
"country_code": "US",
"telephone_number": "503-280-1223",
"fax_number": "503-528-5252",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUNHAM",
"first_name": "KATHLEEN",
"middle_name": "ALISON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-01",
"last_updated": "2024-05-16",
"certification_date": "2024-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "OR",
"license": "MD173822",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.