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

Patan Gultawatvichai, MD

Individual provider Hematology & Oncology Physician · NPI 1720335987

Patan Gultawatvichai, MD is a Hematology/Oncology in Portland, Oregon. Qualified in 2008, 18 years ago. Practices with Oncology Institute OR a Professional Corporation, a 4-clinician group, works from 5 locations, accepts Medicare assignment and offers telehealth. Licensed in Massachusetts and Oregon.

Years since qualifying
18
Licensed in
MA, OR
In the registry since
2012
Specialties on file
2
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

9495 SW Locust St Ste G
Portland, OR 97223-6683
Phone: (971) 314-4522
Fax: (971) 314-4527
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 275 Nichols Rd, Fitchburg, MA 01420-1919 — (978) 343-5048
  • 5 Neponset St, Worcester, MA 01606-2714 — (508) 556-5400
  • 55 Lake Ave N, Worcester, MA 01655 — (508) 334-3550
  • 2720 Commercial St Se, Salem, OR 97302-4495 — (971) 314-4522

Specialties & licences

Hematology & Oncology Physician (primary) Taxonomy 207RH0003X · Licence MD221300 (OR)
Hematology & Oncology Physician Taxonomy 207RH0003X · Licence 274829 (MA)

Record details

NPI number1720335987
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 7, 2012
Last updated in NPPESNovember 27, 2024
Certification dateNovember 27, 2024

Medicare enrollment

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

Medicare specialtyHEMATOLOGY/ONCOLOGY
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Oncology Institute Or A Professional Corporation — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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