Individual provider Active NPI

Lauren A Gorence, PA-C

  • Physician Assistant
  • Tigard, OR
National Provider Identifier
1831482744
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA213688 Issued in OR
Practice address
12442 SW Scholls Ferry Rd Ste 100
Tigard, OR 97223-0803
Phone
(503) 216-9200
NPI assigned
May 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 21637 CA
Physician Assistant 363A00000X PA213688 OR Primary

Addresses

Primary practice location

12442 SW Scholls Ferry Rd Ste 100
Tigard, OR 97223-0803

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

1811 Wilshire Blvd Ste 201
Santa Monica, CA 90403-5626
Phone (310) 566-6330

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lgorence515940@oc.providencedirect.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230221001451 OR Practitioner - Physician Assistant 8628243466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

5050 NE Hoyt St
Suite 454
Portland, OR 97213-2984
Phone (503) 215-6405

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA213688ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Feb 1, 2023 Accepting new patients
Providence Health & Services - Oregon CurrentSince Feb 1, 2023 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

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

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

12442 SW Scholls Ferry Rd
Ste 100
Tigard, OR 97223
Phone (503) 215-9900

29345 SW Town Center Loop E
Ste 110
Wilsonville, OR 97070
Phone (503) 582-2100

Interoperability endpoints

  • Direct secure messaging: lgorence515940@oc.providencedirect.org

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 6

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": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1831482744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12442 SW SCHOLLS FERRY RD STE 100",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972230803",
            "telephone_number": "503-216-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1811 Wilshire Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904035626",
            "country_code": "US",
            "telephone_number": "310-566-6330",
            "fax_number": "310-566-6320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORENCE",
        "first_name": "LAUREN",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "21637",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA213688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgorence515940@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1811 Wilshire Blvd Ste 201",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904035626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.