Olivia Marie Bagot, MD
Individual provider Active NPI Pediatrics Physician · Portland, OR
NPI 1740744770 · NPPES record last updated Nov 20, 2025
Key facts
- NPI
- 1740744770
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD61675980 (WA)
- Practice address
- 8332 SE 13TH Ave
Portland, OR 97202-7102 - Phone
- (503) 595-9300
- NPI assigned
- Jan 23, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- University of California, Davis School of Medicine, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1115 SE 164TH Ave Dept
Suite 358
Vancouver, WA 98683-8004
4545 Cordata Pkwy
Bellingham, WA 98226-7123
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250911004072 | WA | Practitioner - Pediatric Medicine | 5294151668 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD215446 | OR | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sellwood Medical Clinic PC | Current |
Accepting new patients | |
| Peacehealth | Pediatrics | Current |
Accepting new patients |
| Peacehealth | Past |
Accepting new patients |
Locations
8332 SE 13th Ave
Portland, OR 97202
Phone (503) 595-9300
4545 Cordata Pkwy
Ste 1E
Bellingham, WA 98226
Phone (360) 752-5246
4545 Cordata Pkwy
Ste 1F
Bellingham, WA 98226
Phone (360) 752-5246
3015 Squalicum Pkwy
Ste 100
Bellingham, WA 98225
Phone (360) 715-4186
4545 Cordata Pkwy
Bellingham, WA 98226
Phone (360) 752-5646
Interoperability endpoints
- https://api.platform.athenahealth.com/3083/brand/1/csg/1/fhir/r4
- obagot835760@direct.peacehealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD215446 | OR | |
| Pediatrics Physician | 208000000X | MD61675980 | WA | Yes |
Addresses
Primary practice location
8332 SE 13TH Ave
Portland, OR 97202-7102
Mailing address
8332 SE 13TH Ave
Portland, OR 97202-7102
Phone (503) 595-9300
Other practice location 1
4545 Cordata Pkwy Ste 1E
Bellingham, WA 98226-7264
Phone (360) 752-5246
Other providers in Portland, OR
- Jodie Jan Bagley
- Natalie Bagley
- Nicole Marie Bagley
- Rachel L Bagley
- Ted Bagley
- Anthony Bagoyo
- Alexis Kari Bagwell
- Anne Fraser Bagwell
- Katherine A Bagwell
- Lauren Lee Bah
All providers in Portland, OR · Pediatrics Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.