NPIMap

Individual provider Active NPI

Angela Trissandra Marshall-Olson, D.O.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1841493988
Registry record updated Jul 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO29017 Issued in OR
Practice address
1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone
(503) 413-7074
Fax
(503) 413-6769
NPI assigned
Jun 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO29017 OR Primary

Addresses

Primary practice location

1200 NW 23Rd Ave
Portland, OR 97210-2906

Mailing address

1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone (503) 413-7074

Other names 1

  • Angela Trissandra Markham Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091021000302 OR Practitioner - Internal Medicine 4284771429 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

8329 SW Beaverton Hillsdale Hwy
Portland, OR 97225-2215
Phone (503) 414-5160

Hospital & facility affiliations

  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Hillsboro Medical Center Hospital, Hillsboro, OR, CCN 380021

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC Internal Medicine CurrentSince Sep 10, 2009 Accepting new patients
Fanno Creek Clinic LLC Internal Medicine CurrentSince Aug 5, 2015 Accepting new patients
Legacy Clinics LLC CurrentSince Sep 10, 2009 Accepting new patients

Locations

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2400 SW Vermont St
Portland, OR 97219
Phone (503) 452-0915

8329 SW Beaverton Hillsdale Hwy
Portland, OR 97225
Phone (503) 414-5160

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

Interoperability endpoints

  • Direct secure messaging: amarshallolson18913@direct.lhs.org

Organizations & group practices 3

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 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1841493988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NW 23RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102906",
            "telephone_number": "503-413-7074",
            "fax_number": "503-413-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NW 23RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102906",
            "telephone_number": "503-413-7074",
            "fax_number": "503-413-6769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL-OLSON",
        "first_name": "ANGELA",
        "middle_name": "TRISSANDRA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO29017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "MARKHAM",
            "middle_name": "TRISSANDRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.