NPIMap

Individual provider Active NPI

Ellen Elizabeth Lairson, ANP

  • Adult Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1700994225
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
200450154NP Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-4200
Fax
(503) 494-4473
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 200450154NP OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

2944 NE 29TH Ave
Portland, OR 97212-3557
Phone (503) 284-4845

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elairson290248@oc.providencedirect.org

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
I20070118000372 OR Practitioner - Nurse Practitioner 6507842523 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9155 SW Barnes Rd
Suite 238
Portland, OR 97225-6629
Phone (503) 216-0246

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Nov 16, 2019 Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 16, 2019 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Nov 16, 2019 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 16, 2013 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 16, 2013 Accepting new patients
Providence Health & Services - Oregon CurrentSince Nov 16, 2019 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients
Planned Parenthood of the Columbia/Willamette, Inc. Past Accepting new patients

Locations

4805 NE Glisan St
Ste 11N
Portland, OR 97213
Phone (503) 215-1350

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

9135 SW Barnes Rd
Ste 261
Portland, OR 97225
Phone (503) 215-8650

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

9155 SW Barnes Rd
Ste 238
Portland, OR 97225
Phone (503) 223-7214

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

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

Interoperability endpoints

  • Direct secure messaging: elairson290248@oc.providencedirect.org

Organizations & group practices 9

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 2

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1700994225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2944 NE 29TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123557",
            "telephone_number": "503-284-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-4200",
            "fax_number": "503-494-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIRSON",
        "first_name": "ELLEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "200450154NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elairson290248@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9135 SW Barnes Rd Ste 261",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.