Individual provider Active NPI

Mark Huntington Whiteford, MD

  • Colon & Rectal Surgery Physician
  • Portland, OR
National Provider Identifier
1710970892
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
MD21976 Issued in OR
Practice address
4805 NE Glisan St
Suite 6N60
Portland, OR 97213-2933
Phone
(503) 281-0561
Fax
(503) 416-7377
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD21976 OR
Colon & Rectal Surgery Physician 208C00000X MD21976 OR Primary

Addresses

Primary practice location

4805 NE Glisan St
Suite 6N60
Portland, OR 97213-2933

Mailing address

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

Other practice location 1

11000 SW Stratus St Ste 205
Beaverton, OR 97008-7104
Phone (503) 281-0561

Other identifiers 2

IdentifierTypeStateIssuer
134196MedicaidOR
8245078MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_cas_dront_desk_pool12223192@or.progidencedirect.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: 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
I20040419000372 OR Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 4688669716 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
University of Maryland School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

4805 NE Glisan
6N40
Portland, OR 97213-2933
Phone (503) 215-5696

Hospital & facility affiliations

  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD21976ORMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic, PC CurrentSince Apr 1, 2004 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 10, 2013 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 10, 2013 Accepting new patients
The Oregon Clinic PC CurrentSince Apr 1, 2004 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients

Locations

847 NE 19th Ave
Ste 300
Portland, OR 97232

4805 NE Glisan St
Ste 6N40
Portland, OR 97213
Phone (503) 215-5696

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

1111 NE 99th Ave
Ste 301
Portland, OR 97220
Phone (503) 963-2707

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

4805 NE Glisan St
Ste 6N60
Portland, OR 97213
Phone (503) 281-0561

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

Interoperability endpoints

  • Direct secure messaging: mwhiteford133706@oc.providencedirect.org

Organizations & group practices 5

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1710970892",
    "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": "4805 NE GLISAN ST",
            "address_2": "SUITE 6N60",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-281-0561",
            "fax_number": "503-416-7377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11000 SW Stratus St Ste 205",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970087104",
            "country_code": "US",
            "telephone_number": "503-281-0561",
            "fax_number": "503-416-7377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITEFORD",
        "first_name": "MARK",
        "middle_name": "HUNTINGTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD21976",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "OR",
            "license": "MD21976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134196",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8245078",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_cas_dront_desk_pool12223192@or.progidencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "4805 NE Glisan St",
            "address_2": "Suite 6N60",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.