Individual provider Active NPI

Alisa Cherie Gifford, PA

  • Physician Assistant
  • Beaverton, OR
National Provider Identifier
1689993255
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA185957 Issued in OR
Practice address
6800 SW 105TH Ave Ste 206
Beaverton, OR 97008-5487
Phone
(503) 430-1777
Fax
(503) 372-5119
NPI assigned
May 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA185957 OR Primary

Addresses

Primary practice location

6800 SW 105TH Ave Ste 206
Beaverton, OR 97008-5487

Mailing address

6800 SW 105TH Ave Ste 206
Beaverton, OR 97008-5487
Phone (503) 430-1777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100817000745 AZ Practitioner - Physician Assistant 4789718461
I20180131002330 OR Practitioner - Physician Assistant 4789718461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRM Physicians LLCGroup PAC ID 3678720729, 59 clinicians

Practice addresses (Care Compare)

650 SE Oak St
Hillsboro, OR 97123-4120
Phone (503) 648-8588

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mark W Cheng LLC Past Accepting new patients

Organizations & group practices 2

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": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1689993255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 SW 105TH AVE STE 206",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970085487",
            "telephone_number": "503-430-1777",
            "fax_number": "503-372-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 SW 105TH AVE STE 206",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970085487",
            "telephone_number": "503-430-1777",
            "fax_number": "503-372-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIFFORD",
        "first_name": "ALISA",
        "middle_name": "CHERIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-21",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA185957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.