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MICHAEL P. GARDNER, MD PC
NPI 1043684889
Clinic/Center in Tualatin, OR

Active since November 17, 2015CLIA 38D2015814 · Microscopy
19260 SW 65TH AVE STE 310, TUALATIN, OR 97062(503) 692-1200(503) 692-1220 Get Directions Write a Review

NPPES record last updated: January 29, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 29, 2020, Nov 30, 2015, Nov 17, 2015 (3 updates tracked since 2015).

About Michael P. Gardner, Md Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL P. GARDNER, MD PC (NPI 1043684889) is a healthcare organization registered as a clinic/center in Tualatin, Oregon and active in the NPI registry since November 2015. The organization holds a CLIA Microscopy certificate valid through November 3, 2026 and lists Shelly Banta, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1043684889
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameMICHAEL P. GARDNER, MD PC
Location Address19260 SW 65TH AVE STE 310Tualatin, OR 97062-5710
Mailing Address19260 Sw 65th Ave Ste 310Tualatin, OR 97062-5710 · (503) 692-1200 · Fax (503) 692-1220
Phone(503) 692-1200
Fax(503) 692-1220
Organization SubpartNo
Authorized OfficialShelly BantaOffice Manager · (503) 783-0208
Enumeration DateNovember 17, 2015
Last NPPES UpdateJanuary 29, 20203 updates tracked since enumeration
✔ NPI 1043684889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in OR · MD22270
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
19260 SW 65TH AVE STE 310, Tualatin, OR 97062
Open in Google Maps ↗

Other Identifiers 1

Medicaid288387OR

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 38D2015814

Michael P Gardner MD · Tualatin, OR
Active · expires Nov 3, 2026
CLIA Number38D2015814
Laboratory TypePhysician Office
Certificate Effective DateNovember 4, 2024
Certificate Expiration DateNovember 3, 2026
Laboratory DirectorMichael P Garner MD
Laboratory Phone(503) 692-1200
Laboratory LocationMichael P Gardner MD19260 SW 65th Ave Suite 310, Tualatin, OR 97062
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL P. GARDNER, MD PC
Urology
19260 SW 65TH AVE STE 310
TUALATIN, OR 97062
Washington County (503) 692-1200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael P. Gardner, MD PC's NPI number?

The NPI number for Michael P. Gardner, MD PC is 1043684889. It was assigned to this organization in the NPPES registry on November 17, 2015.

Where is Michael P. Gardner, MD PC located?

Michael P. Gardner, MD PC is located at 19260 SW 65th Ave Ste 310, Tualatin, OR 97062. The listed phone number is (503) 692-1200.

What is Michael P. Gardner, MD PC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Michael P. Gardner, MD PC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 38D2015814) is associated with this NPI, valid through November 3, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Michael P. Gardner, MD PC was last updated on January 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.