Individual provider Active NPI

Gillian Lam, M.D.

  • Pediatric Gastroenterology Physician
  • Portland, OR
National Provider Identifier
1306166038
Registry record updated Apr 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
177049 Issued in OR
Practice address
700 SW Campus Dr
7TH Floor
Portland, OR 97239-3107
Phone
(503) 346-0640
NPI assigned
Jun 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X E-10228 AR
Pediatric Gastroenterology Physician 2080P0206X 177049 OR Primary

Addresses

Primary practice location

700 SW Campus Dr
7TH Floor
Portland, OR 97239-3107

Mailing address

707 SW Gaines St, Cdrcp
Peds Gi, Office 4212
Portland, OR 97239-2403
Phone (503) 494-1078

Other names 1

  • Dr. Gillian Tam Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170329002758 OR Practitioner - Pediatric Medicine 9436433547 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
177049ORMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince May 1, 2017 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince May 1, 2017 Accepting new patients
University Professional Services Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

901 E 18th Ave
Eugene, OR 97403
Phone (541) 346-3575

707 SW Gaines St
Ofc 4212
Portland, OR 97239

875 Oak St SE
Salem, OR 97301
Phone (503) 561-5719

875 Oak St SE
Ste 3040
Salem, OR 97301
Phone (503) 494-4808

891 23rd St NE
Salem, OR 97301
Phone (503) 364-2181

Interoperability endpoints

  • Direct secure messaging: glammd101313@direct.ohsu.edu

Organizations & group practices 4

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": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491696000000",
    "number": "1306166038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 SW GAINES ST, CDRCP",
            "address_2": "PEDS GI, OFFICE 4212",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392403",
            "telephone_number": "503-494-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SW CAMPUS DR",
            "address_2": "7TH FLOOR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393107",
            "telephone_number": "503-346-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "GILLIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2017-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "AR",
            "license": "E-10228",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "OR",
            "license": "177049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GILLIAN",
            "last_name": "TAM",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.