A CPA for medical and dental practices in Portland

Why Portland practices work with a CPA for medical and dental practices

A family dental office in Tigard, a physical therapy clinic in Hillsboro, a two doctor medical practice near the hospitals on Marquam Hill. Practice owners in the Portland area tend to be very good at their work and very short on time for anything else.

Running a practice means payroll for front desk and clinical staff, equipment that costs as much as a house, insurance payments that arrive weeks after the visit, and an owner whose personal income is often high enough to trigger every extra local tax in the region. Each of those pieces has tax consequences.

Every request through Accountants Portland goes to a licensed CPA in our Portland area network who works with healthcare practices. They can look after the practice return and your personal return together, so one decision does not create a problem on the other side.

Many owners first reach out when something changes: a new associate, a second location, a partner retiring or a letter from a tax agency. Those moments are a good time to step back and check that the whole setup still fits.

Choosing a structure for your practice

An Oregon practice may be set up as a professional corporation, an LLC or a partnership, and the entity is filed with the Oregon Secretary of State. The licensing board for your profession may also have rules about who can own the practice, so the legal side should be checked with an attorney.

The tax side is where a CPA helps. A practice taxed as an S corp passes profit through to the owners, who pay themselves a reasonable salary through payroll. A partnership files Form 1065 and gives each owner a Schedule K-1. A C corporation pays tax at the company level. Each choice changes how much tax you pay and how much paperwork you carry.

If you are buying into an existing practice or bringing on a new partner, the structure question comes up again. Planning before the agreement is signed gives you far more options than fixing it after.

Owners sometimes keep the building in a separate entity and lease it to the practice. That can make sense for liability and estate planning, but the lease terms and the rental side of the return need to be handled carefully so both entities report the same numbers.

Payroll for clinical and office staff

Most practices have a mix of hygienists, assistants, nurses, therapists and front office staff. Oregon payroll includes the statewide transit tax of 0.1% withheld from each employee and, for practices in the TriMet district, the TriMet transit payroll tax paid by the employer at 0.8237% for 2025 and 2026.

Paid Leave Oregon contributions are 1% of wages for 2026. Employees pay 60%, and employers with 25 or more employees on average pay the other 40%. Larger group practices often cross that line as they grow.

Practices also need to watch Metro and Multnomah County withholding. Employers must withhold those personal income taxes for employees who earn over $200,000 or who opt in. Highly paid associates may cross that line, so payroll setup matters.

Benefits add another layer. Health coverage, continuing education support and uniform allowances can each be handled in more than one way for tax purposes. A CPA can check that the way your practice provides them matches how payroll reports them.

Equipment, buildouts and practice purchases

Dental chairs, imaging systems, lasers and practice management software are major costs. So is building out a suite in a medical office building. How you finance and depreciate these purchases can move your tax bill a great deal from year to year.

A CPA can help you plan large purchases around your income, choose depreciation methods and keep records that support each deduction. Buying a practice is a bigger version of the same question. How the price is split between equipment, goodwill and other assets affects both buyer and seller for years.

Good bookkeeping makes all of this easier. Clean monthly numbers show production, collections and overhead, which helps with staffing and pricing decisions as well as taxes.

Insurance billing adds a timing wrinkle. Collections can lag production by weeks or months, so the cash method and accrual books can tell different stories about the same year. A CPA can show you both views and explain which one your tax return uses.

Oregon CAT and Portland area business taxes

Practices with strong collections can reach the Oregon Corporate Activity Tax thresholds. Registration is required within 30 days of reaching $750,000 in Oregon commercial activity for the year, and a return is due once you are over $1 million. The tax is $250 plus 0.57% of taxable commercial activity over $1 million, after subtracting 35% of the greater of cost inputs or labor costs.

Practices in Portland or Multnomah County usually file the combined City of Portland and Multnomah County business tax return. On the 2025 forms the city rate is 2.6% and the county rate is 2%, each with a $100 minimum.

Larger groups may also owe the Metro Supportive Housing Services business income tax, which Metro describes as 1% of net income for businesses with gross receipts above $5 million.

Personal taxes for high earning practice owners

Most practice owners pay more in personal tax than the practice pays itself, especially when profit passes through. In the Portland area that can include the Metro Supportive Housing Services tax of 1% of Metro taxable income above $125,000 single or $200,000 joint for tax years through 2025, and above $128,000 or $205,000 for 2026.

Owners who live or work in Multnomah County may also owe the Preschool for All tax, which is 1.5% above $125,000 single or $200,000 joint and another 1.5% above $250,000 single or $400,000 joint. These taxes are filed with the City of Portland, not on the Oregon return.

Quarterly estimates for these local taxes are required from tax year 2026 once your liability for each reaches $5,000. A CPA who sees both the practice books and your personal return can set one plan for federal, Oregon and local estimates.

Retirement plans and year end planning

Retirement plans are one of the main planning tools for practice owners. The right plan depends on how many employees you have, how old they are and how much you want to put away. Limits change every year, so your CPA checks the current figures for your tax year before you choose.

Year end planning usually covers timing of equipment purchases, owner salary levels in an S corp, bonuses for staff and estimated payments. A short meeting before the year closes often saves more than any deduction found after the fact.

Practice owners close to retirement have another set of questions, from selling the practice to an associate to winding down gradually. The tax result of each path can differ a lot, and the best options usually need a few years of lead time.

Common questions