Individual provider Active NPI

Dana G Eustis, MD

  • Obstetrics & Gynecology Physician
  • Gresham, OR
National Provider Identifier
1235517376
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD199560 Issued in OR
Practice address
24800 SE Stark St
Gresham, OR 97030-3378
Phone
(503) 491-9444
NPI assigned
May 8, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD199560 OR Primary

Addresses

Primary practice location

24800 SE Stark St
Gresham, OR 97030-3378

Mailing address

7650 SW Beveland Rd Ste 200
Portland, OR 97223-8692
Phone (503) 601-3615

Other practice location 1

19250 SW 65th Ave Ste 300
Tualatin, OR 97062-7707
Phone (503) 692-1242

Other identifiers 1

IdentifierTypeStateIssuer
500782792MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200813002860 OR Practitioner - Obstetrics/Gynecology 1557634425 Reassigns benefits to 2 organizations
I20240313004123 WA Practitioner - Obstetrics/Gynecology 1557634425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Rush Medical College of Rush University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

24800 SE Stark St
Gresham, OR 97030-3378
Phone (503) 413-8988

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD199560ORMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Jun 19, 2025 Accepting new patients
Peacehealth CurrentSince Apr 15, 2024 Accepting new patients
Obhg Washington, PC Obstetrics & Gynecology CurrentSince Jan 20, 2024 Accepting new patients
Legacy Clinics LLC Family Medicine CurrentSince Jun 19, 2025 Accepting new patients
Peacehealth Family Medicine Past Accepting new patients
Northwest Urology, LLC Past Accepting new patients
Women'S Healthcare Associates, LLC PastSince Sep 3, 2025 Accepting new patients

Locations

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

19250 SW 65th Ave
Ste 300
Tualatin, OR 97062
Phone (503) 692-1242

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

1800 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 337-8800

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

505 NE 87th Ave
Ste 160
Vancouver, WA 98664
Phone (360) 256-4500

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

1115 SE 164th Ave
Vancouver, WA 98683
Phone (360) 729-1412

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

Interoperability endpoints

  • Direct secure messaging: deustis506736@direct.lhs.org
  • Direct secure messaging: deustis650333@direct.peacehealth.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1235517376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7650 SW BEVELAND RD STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238692",
            "telephone_number": "503-601-3615",
            "fax_number": "503-646-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24800 SE STARK ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303378",
            "telephone_number": "503-491-9444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19250 SW 65th Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "970627707",
            "country_code": "US",
            "telephone_number": "503-692-1242",
            "fax_number": "503-691-3615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EUSTIS",
        "first_name": "DANA",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-08",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD199560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500782792",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.