Individual provider Active NPI

Dawn Marie Larson, M.D.

  • Anesthesiology Physician
  • Portland, OR
National Provider Identifier
1710130976
Registry record updated Oct 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD28717 Issued in OR
Practice address
707 SW Washington St
Suite 700
Portland, OR 97205-3536
Phone
(503) 299-9906
Fax
(503) 225-9002
NPI assigned
Oct 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X MD28717 OR
Anesthesiology Physician 207L00000X MD28717 OR Primary

Addresses

Primary practice location

707 SW Washington St
Suite 700
Portland, OR 97205-3536

Mailing address

PO Box 35147
#1801
Seattle, WA 98124-5147
Phone (503) 299-9906

Other identifiers 1

IdentifierTypeStateIssuer
500634272MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110503000131 OR Practitioner - Anesthesiology 6305021528 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Washington - TCSGroup PAC ID 6800240102, 197 clinicians

Practice addresses (Care Compare)

4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 215-1111

9205 SW Barnes Rd
Portland, OR 97225-6603
Phone (503) 216-1234

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Feb 1, 2016 Accepting new patients
Hospitalist Medicine Physicians of Washington - TCS Anesthesiology CurrentSince Jan 8, 2024 Accepting new patients
Oag Trauma Services LLC Anesthesiology PastSince Sep 1, 2015 Accepting new patients

Locations

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

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

Organizations & group practices 4

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 1

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": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1710130976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35147",
            "address_2": "#1801",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245147",
            "telephone_number": "503-299-9906",
            "fax_number": "503-225-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SW WASHINGTON ST",
            "address_2": "SUITE 700",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972053536",
            "telephone_number": "503-299-9906",
            "fax_number": "503-225-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "OR",
            "license": "MD28717",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD28717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500634272",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.