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

Thomas David Sanderson, AGACNP

Individual provider Emergency Registered Nurse · NPI 1275171316

Thomas David Sanderson, AGACNP is a Nurse Practitioner in Portland, Oregon. Qualified in 2018, 8 years ago. Practices with Providence Health and Services Oregon, a 1,426-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
8
Licensed in
OR
In the registry since
2019
Specialties on file
3
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Practice location Address checks out

4400 NE Halsey St Ste 102
Portland, OR 97213-1545
Phone: (503) 962-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 148 E Hersey St, Ashland, OR 97520-1359 — (541) 552-1111

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 201904283NP-PP (OR)
Emergency Registered Nurse Taxonomy 163WE0003X · Licence 201904282RN (OR)
Nurse Practitioner Taxonomy 363L00000X · Licence 201904283NP-PP (OR)

Record details

NPI number1275171316
Entity typeIndividual (Type 1)
GenderMale
Credentials AGACNP
Sole proprietorNo
NPI enumeratedDecember 19, 2019
Last updated in NPPESApril 3, 2026
Certification dateApril 3, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Providence Health And Services Oregon — 1426 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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