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

Mark Kenneth Wax, MD

Individual provider Otolaryngology Physician · NPI 1912912429

Mark Kenneth Wax, MD is a Plastic and Reconstructive Surgery in Portland, Oregon. Qualified in 1980, 46 years ago. Practices with University Professional Services, a 1,704-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
46
Licensed in
OR
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 494-5674
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X · Licence MD21318 (OR)

Record details

NPI number1912912429
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 31, 2006
Last updated in NPPESJuly 17, 2007
Mailing address3181 Sw Sam Jackson Park Rd # 01, Portland, OR 97239-3098

Medicare enrollment

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

Medicare specialtyPLASTIC AND RECONSTRUCTIVE SURGERY
Also practisesOTOLARYNGOLOGY
Medical schoolOTHER
Graduated 1980 (46 years in practice)
Group practice University Professional Services — 1704 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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