NPIMap

Individual provider Active NPI

Amy Marilyn Woodson, PA-C

  • Physician Assistant
  • Gresham, OR
National Provider Identifier
1437422953
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA218635 Issued in OR
Practice address
24076 SE Stark St Ste 230
Gresham, OR 97030-3385
Phone
(503) 488-2600
Fax
(503) 465-5468
NPI assigned
Feb 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA218635 OR Primary
Physician Assistant 363A00000X 5601006245 MI

Addresses

Primary practice location

24076 SE Stark St Ste 230
Gresham, OR 97030-3385

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other practice location 1

1111 NE 99th Ave Ste 101
Portland, OR 97220-9442
Phone (503) 488-2600

Other identifiers 2

IdentifierTypeStateIssuer
500834098MedicaidOR
2285263MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_ent_east_front_desk_pool12223123@or.providencedirect.org The Oregon Clinic PC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240401001618 OR Practitioner - Physician Assistant 1951695014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

1111 NE 99TH Ave
Portland, OR 97220-9442

5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673

Hospital & facility affiliations

  • Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601006245MIMDPhysician Assistant
PA218635ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic, PC CurrentSince Mar 18, 2024 Accepting new patients
Providence Health & Services - Oregon CurrentSince May 1, 2024 Accepting new patients
Providence Health & Services Oregon CurrentSince May 1, 2024 Accepting new patients
Allergy & Asthma Associates of Mi PC PastSince Jun 1, 2020 Accepting new patients
Holland Community Hospital Physician Assistant Past Accepting new patients
Allergy & Asthma Physicians of Royal Oak PC PastSince Jun 1, 2020 Accepting new patients

Locations

24076 SE Stark St
Ste 230
Gresham, OR 97030
Phone (503) 465-5461

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

1111 NE 99th Ave
Ste 101
Portland, OR 97220
Phone (503) 488-2600

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

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

Interoperability endpoints

  • Direct secure messaging: awoodson3204472@oc.providencedirect.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1437422953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST STE 230",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303385",
            "telephone_number": "503-488-2600",
            "fax_number": "503-465-5468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 NE 99th Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972209442",
            "country_code": "US",
            "telephone_number": "503-488-2600",
            "fax_number": "503-488-2630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODSON",
        "first_name": "AMY",
        "middle_name": "MARILYN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-14",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA218635",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006245",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500834098",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2285263",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_ent_east_front_desk_pool12223123@or.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "24076 SE Stark St Ste 230",
            "city": "Gresham",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970303385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.