Active NPI
Michelle Lee
- Pediatric Neurodevelopmental Disabilities Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Neurodevelopmental Disabilities Physician
- License
- MD225807
- Practice address
- 3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011 - Phone
- (503) 494-5856
- Fax
- (503) 494-2370
- NPI assigned
- Jul 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2019022747 | MO | |
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | MD225807 | OR | |
| Pediatric Neurodevelopmental Disabilities Physician | 2080P0008X | MD225807 | OR | Primary |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Mailing address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-5856
Other practice location 1
1 Childrens Pl # 3S34
Saint Louis, MO 63110-1002
Phone (314) 454-6006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019022747 | MO | MD | Pediatrics Physician |
| MD225807 | OR | MD | Neurology with Special Qualifications in Child Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Pediatrics | Past | Accepting new patients |
Locations
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
1500 NW Bethany Blvd
Beaverton, OR 97006
Phone (503) 567-3260
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674
Interoperability endpoints
- mlee200888@direct.ohsu.edu
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Portland, OR
- NPI 1376709535
-
- Pharmacy
- Beaverton, OR
- NPI 1073054714
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Portland, OR
- NPI 1316354970
-
- Pediatrics Physician
- Medford, OR
- NPI 1225282122
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757376000000",
"number": "1124670989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-494-5856",
"fax_number": "503-494-2370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-494-5856",
"fax_number": "503-494-2370"
}
],
"practiceLocations": [
{
"address_1": "1 Childrens Pl # 3S34",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631101002",
"country_code": "US",
"telephone_number": "314-454-6006",
"fax_number": "314-454-4102",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-11",
"last_updated": "2025-09-09",
"certification_date": "2025-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2019022747",
"primary": false
},
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "OR",
"license": "MD225807",
"primary": false
},
{
"code": "2080P0008X",
"taxonomy_group": "",
"desc": "Pediatrics, Neurodevelopmental Disabilities",
"state": "OR",
"license": "MD225807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.