Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lisa Andersen

Individual provider Surgical Physician Assistant · NPI 1730484312

Lisa Andersen is a Physician Assistant in Portland, Oregon. Qualified in 2012, 14 years ago. Practices with Legacy Clinics LLC, a 718-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
14
Licensed in
OR
In the registry since
2011

Practice location Address checks out

5050 NE Hoyt St Ste 138
Portland, OR 97213-2955
Phone: (503) 238-1062
Fax: (503) 233-1588
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA160150 (OR)

Record details

NPI number1730484312
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 13, 2011
Last updated in NPPESFebruary 17, 2014
Mailing address5050 Ne Hoyt St Ste 138, Portland, OR 97213-2955

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Portland