NPIMap

Individual provider Active NPI

Douglas Michael Lackowski, M.D.

  • Medical Oncology Physician
  • Portland, OR
National Provider Identifier
1831292861
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
MD18334 Issued in OR
Practice address
3600 N Interstate Ave
Interstate Medical Office Central
Portland, OR 97227-1106
Phone
(503) 285-9321
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X WA MD00032902 WA
Medical Oncology Physician 207RX0202X MD18334 OR Primary

Addresses

Primary practice location

3600 N Interstate Ave
Interstate Medical Office Central
Portland, OR 97227-1106

Mailing address

Kaiser Permanente Interstate Medical Office Central
3600 N. Interstate Ave
Portland, OR 97227-1116

Other practice location 1

15700 SW Greystone Ct
Beaverton, OR 97006-6011
Phone (971) 262-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Northwest Permanente PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080114000115 OR Practitioner - Hematology/OncologyPractitioner - Internal MedicinePractitioner - HematologyPractitioner - Medical Oncology 7012098361 Reassigns benefits to 2 organizations
I20100127000867 WA Practitioner - Hematology/OncologyPractitioner - Medical Oncology 7012098361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Hematology, Internal Medicine
Education
University of South Carolina School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 203-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.56 of 100Reported as group
Quality
95.87
Promoting interoperability
100
Improvement activities
40
Cost
75.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
WA MD00032902WAMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 13, 2009 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Dec 1, 2022 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Dec 1, 2022 Accepting new patients
University Professional Services CurrentSince Jun 1, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 13, 2009 Accepting new patients
University Professional Services Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 13, 2009 Accepting new patients
University Professional Services CurrentSince Jun 1, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

3600 N Interstate Ave
Ofc
Portland, OR 97227
Phone (503) 285-9321

3600 N Interstate Ave
Portland, OR 97227
Phone (503) 285-9321

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

10452 Silverdale Way NW
Silverdale, WA 98383
Phone (360) 307-7300

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: dlackowski476495@direct.peacehealth.org
  • Direct secure messaging: dlackowski197305@direct.ohsu.edu

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 5

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1831292861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KAISER PERMANENTE INTERSTATE MEDICAL OFFICE CENTRAL",
            "address_2": "3600 N. INTERSTATE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 N INTERSTATE AVE",
            "address_2": "INTERSTATE MEDICAL OFFICE CENTRAL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271106",
            "telephone_number": "503-285-9321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15700 SW Greystone Ct",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970066011",
            "country_code": "US",
            "telephone_number": "971-262-9000",
            "fax_number": "971-262-9010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACKOWSKI",
        "first_name": "DOUGLAS",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "WA",
            "license": "WA MD00032902",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "OR",
            "license": "MD18334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Northwest Permanente PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3600 N Interstate Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972271106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.