Individual provider Active NPI

Alisa Larson Doumaney, CRNA

  • Certified Registered Nurse Anesthetist
  • Portland, OR
National Provider Identifier
1245034958
Registry record updated Aug 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
10045113 Issued in OR
Practice address
4805 NE Glisan St
Portland, OR 97213-2933
Phone
(503) 215-1111
NPI assigned
Apr 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 10045113 OR Primary

Addresses

Primary practice location

4805 NE Glisan St
Portland, OR 97213-2933

Mailing address

4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 215-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250903001724 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365943040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Washington - TCSGroup PAC ID 6800240102, 197 clinicians

Practice addresses (Care Compare)

4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 215-1111

Hospital & facility affiliations

  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10045113ORMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Washington - TCS Nurse Anesthetist, Certified Registered CurrentSince Jun 20, 2025 Accepting new patients

Locations

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

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 2

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": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785628800000",
    "number": "1245034958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUMANEY",
        "first_name": "ALISA",
        "middle_name": "LARSON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-02",
        "last_updated": "2026-08-02",
        "certification_date": "2026-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "10045113",
            "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 Aug 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.