MARCUS CORNWALL, DOPC - NPI 1154514446 - Clinic/Center in Milwaukie, OR

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.

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About Marcus Cornwall, Dopc NPPES

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

MARCUS CORNWALL, DOPC (NPI 1154514446) is a healthcare organization registered as a primary care in Milwaukie, Oregon and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through March 30, 2028 and lists Marcus H Cornwall, Physician And Owner, as its authorized official.

NPPES Registry Identity

NPI1154514446

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameMARCUS CORNWALL, DOPC

Location Address6542 SE LAKE RD STE 202Milwaukie, OR 97222-2245

Mailing Address6542 Se Lake Rd Ste 202Milwaukie, OR 97222-2245 · (503) 233-5273 · Fax (855) 492-8902

Phone(503) 233-5273

Fax(855) 492-8902

Organization SubpartNo

Authorized OfficialMarcus H CornwallPhysician And Owner · (503) 233-5273

Enumeration DateAugust 21, 2007

Last NPPES UpdateDecember 7, 2023

NPPES CertifiedDecember 7, 2023

✔ NPI 1154514446 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

License✔ Licensed in OR · DO23052

6542 SE LAKE RD STE 202, Milwaukie, OR 97222

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

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 of Waiver 38D2181298

Marcus Cornwall, Do, PC · Milwaukie, OR

Active · expires Mar 30, 2028

CLIA Number38D2181298

Laboratory TypePhysician Office

Certificate Effective DateMarch 31, 2026

Certificate Expiration DateMarch 30, 2028

Laboratory DirectorMarcus H. Cornwall

Laboratory Phone(503) 233-5273

Laboratory LocationMarcus Cornwall, Do, PC6542 SE Lake Road, Suite 202, Milwaukie, OR 97222

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

PACIFIC PAIN MANAGEMENT PC

Pain Medicine (Interventional Pain Medicine)