NPIMap

Individual provider Active NPI

Jesse Y Liu

  • Dermatology Physician
  • Portland, OR
National Provider Identifier
1356845523
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD223656 Issued in OR
Practice address
3303 S Bond Ave
Portland, OR 97239-4501
Phone
(503) 418-3376
NPI assigned
Mar 21, 2018
Last updated
Apr 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 25MA11464700 NJ
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X MD223656 OR Primary

Addresses

Primary practice location

3303 S Bond Ave
Portland, OR 97239-4501

Mailing address

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 418-3376

Other practice location 1

1 Seymour St
Montclair, NJ 07042-3771
Phone (973) 302-9585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240409002770 WA Practitioner - Dermatology 9032465158 Reassigns benefits to 1 organization
I20250409000850 OR Practitioner - Dermatology 9032465158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Duke University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision25
Removal of skin lesions269
Skin biopsy163

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Apr 1, 2025 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Apr 9, 2024 Accepting new patients
University Professional Services CurrentSince Apr 1, 2025 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Apr 9, 2024 Accepting new patients
The Vancouver Clinic Inc PS Dermatology Current Accepting new patients

Locations

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

6355 NE Cornell Rd
Hillsboro, OR 97124
Phone (503) 418-3376

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

501 SE 172nd Ave
Vancouver, WA 98684

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

Interoperability endpoints

  • Direct secure messaging: jliu196210@direct.ohsu.edu

Organizations & group practices 5

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1356845523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-418-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-418-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Seymour St",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "070423771",
            "country_code": "US",
            "telephone_number": "973-302-9585",
            "fax_number": "862-357-8421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "JESSE",
        "middle_name": "Y",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA11464700",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OR",
            "license": "MD223656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.