Active NPI
Marion Lee Gardner Jr., MD
- Family Medicine Physician
- North Plains, OR
National Provider Identifier
1740382480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD17617
- Practice address
- 10245 NW Glencoe Rd
North Plains, OR 97133-8233 - Phone
- (503) 647-9261
- Fax
- (503) 647-1230
- NPI assigned
- Sep 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD17617 | OR | Primary |
Addresses
Primary practice location
10245 NW Glencoe Rd
North Plains, OR 97133-8233
Mailing address
10245 NW Glencoe Rd
North Plains, OR 97133-8233
Phone (503) 647-9261
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 044292 | Medicaid | OR |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031122000116 | OR | Practitioner - Family Practice | 7911801766 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Oregon Health Sciences University School of Medicine, 1990
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
10245 NW Glencoe Rd
North Plains, OR 97133-8233
Hospital & facility affiliations
- Amedisys Home Health Care
- Providence Home Health
- Hillsboro Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 16 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD17617 | OR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Primary Care Group, PC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Milwaukie, OR
- NPI 1558572180
Hospital & facility affiliations 14
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Portland, OR
- NPI 1134311988
-
- Home Health Agency
- Portland, OR
- NPI 1790873461
-
- Psychiatric Hospital
- Hillsboro, OR
- NPI 1073817714
-
- General Acute Care Hospital
- Hillsboro, OR
- NPI 1275591984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764720000000",
"number": "1740382480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10245 NW GLENCOE RD",
"city": "NORTH PLAINS",
"state": "OR",
"postal_code": "971338233",
"telephone_number": "503-647-9261",
"fax_number": "503-647-1230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10245 NW GLENCOE RD",
"city": "NORTH PLAINS",
"state": "OR",
"postal_code": "971338233",
"telephone_number": "503-647-9261",
"fax_number": "503-647-1230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "MARION",
"middle_name": "LEE",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-02",
"last_updated": "2025-12-03",
"certification_date": "2025-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD17617",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "044292",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Plains, OR
- Jean Habecker Cuyler, RADIOLOGIC TECH
- Candace Louise Enslow, RDH
- Shane E Espinoza, D.C. CCSP
- Fabulous Healing Nutrition & Wellness LLC
- August Elaine Gannett
- Jessica Mae Garrison, DC
- Auzadeh Harvey, LPC, LPCC, MS, NCC
- JGL Care Mobility LLC
- Hannah Kathryn Jones, NUTRITIONIST
- Halina Kowalski, MA, LPC, NCC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.