Individual provider Active NPI

Jennifer L Larson, M.D.

  • Emergency Medicine Physician
  • Happy Valley, OR
National Provider Identifier
1679512347
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD25904 Issued in OR
Practice address
16180 SE Sunnyside Rd Ste 102
Happy Valley, OR 97015-6302
Phone
(503) 582-4900
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD25904 OR Primary

Addresses

Primary practice location

16180 SE Sunnyside Rd Ste 102
Happy Valley, OR 97015-6302

Mailing address

16180 SE Sunnyside Rd Ste 102
Happy Valley, OR 97015-6302

Other practice location 1

1700 E 19th St
The Dalles, OR 97058-3317
Phone (541) 296-1111

Other identifiers 5

IdentifierTypeStateIssuer
273851MedicaidOR
865374000OtherBCBS OF OR
8940758OtherWA CRIME VICTIMS
0205695OtherWA L & I
P00276313OtherRAILROAD MEDICARE

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
I20060215000388 OR Practitioner - Emergency Medicine 4486669256 Reassigns benefits to 5 organizations
I20201216001349 WA Practitioner - Emergency Medicine 4486669256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Oregon Health Sciences University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

16180 SE Sunnyside Rd
Suite 102
Happy Valley, OR 97015-6302
Phone (503) 582-4900

Hospital & facility affiliations

  • Mid-Columbia Medical Center Hospital, The Dalles, OR, CCN 380001
  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082
  • Providence Hood River Memorial Hospital Hospital, Hood River, OR, CCN 381318

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Medical Foundation of Tillamook Current Accepting new patients
Mid-Columbia Medical Center CurrentSince May 1, 2019 Accepting new patients
Public Hospital District No 2, Klickitat County, Washington CurrentSince May 27, 2022 Accepting new patients
Providence Health & Services Oregon Emergency Medicine Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Nov 17, 2025 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 4, 2021 Accepting new patients
Public Hospital District No. 2, Klickitat County, Washington Current Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 17, 2025 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 4, 2021 Accepting new patients
Northwest Medical Foundation of Tillamook CurrentSince Nov 19, 2020 Accepting new patients
Public Hospital District No 2, Klickitat County Washington CurrentSince May 27, 2022 Accepting new patients
Northwest Medical Foundation of Tillamook CurrentSince Nov 19, 2020 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients

Locations

200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

16180 SE Sunnyside Rd
Ste 102
Happy Valley, OR 97015
Phone (503) 582-4900

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

1321 NE 99th Ave
Ste 100
Portland, OR 97220
Phone (503) 215-4050

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

960 N 16th St
Ste 304
Springfield, OR 97477
Phone (541) 744-6172

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

1810 E 19th St
Ste 211
The Dalles, OR 97058
Phone (503) 292-1400

12442 SW Scholls Ferry Rd
Ste 100
Tigard, OR 97223
Phone (503) 215-9900

1000 3rd St
#M
Tillamook, OR 97141
Phone (503) 815-2260

1000 3rd St
Tillamook, OR 97141
Phone (503) 251-6129

Interoperability endpoints

  • Direct secure messaging: jlarson92057@direct.ohsu.edu
  • FHIR API: https://fhir-myrecord.cerner.com/r4/ac6e817f-dc27-43e8-b886-6559f137e853/
  • Direct secure messaging: jlarson474702@oc.providencedirect.org

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 3

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1679512347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16180 SE SUNNYSIDE RD STE 102",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970156302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16180 SE SUNNYSIDE RD STE 102",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970156302",
            "telephone_number": "503-582-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 E 19th St",
            "address_purpose": "LOCATION",
            "city": "The Dalles",
            "state": "OR",
            "postal_code": "970583317",
            "country_code": "US",
            "telephone_number": "541-296-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD25904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273851",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF OR",
            "identifier": "865374000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA CRIME VICTIMS",
            "identifier": "8940758",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L & I",
            "identifier": "0205695",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00276313",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Happy Valley, OR

Sources for this page

Verify at the official NPI Registry.