Individual provider Active NPI

Michael Dawson, NP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1235408048
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201806622NP-PP Issued in OR
Practice address
5100 SW Macadam Ave Ste 200
Portland, OR 97239-3827
Phone
(917) 202-5500
Fax
(917) 202-5555
NPI assigned
Dec 22, 2011
Last updated
Jan 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 340831 NY
Gerontology Nurse Practitioner 363LG0600X 201806622NP-PP OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61029814 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201806622NP-PP OR Primary

Addresses

Primary practice location

5100 SW Macadam Ave Ste 200
Portland, OR 97239-3827

Mailing address

5100 SW Macadam Ave Ste 200
Portland, OR 97239-3827
Phone (646) 342-6446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200212000650 OR Practitioner - Nurse Practitioner 3971759143 Reassigns benefits to 2 organizations
I20200917001561 WA Practitioner - Nurse Practitioner 3971759143 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sokyahealth Medical Group PCGroup PAC ID 9739575648, 68 clinicians

Practice addresses (Care Compare)

4800 S Macadam Ave
Suite 230
Portland, OR 97239-3927
Phone (877) 840-6956

5109 NE 82ND Ave
Suite 215
Vancouver, WA 98662-6841
Phone (877) 840-6956

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
340831NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carelon Medical Partners, PC CurrentSince Sep 14, 2020 Accepting new patients
Sokyahealth Medical Group PC Psychiatric/Mental Health CurrentSince Jan 7, 2025 Accepting new patients
Headlight Health Medical Group PLLC Psychiatric/Mental Health CurrentSince Feb 25, 2026 Accepting new patients

Locations

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

4800 S Macadam Ave
Ste 230
Portland, OR 97239
Phone (866) 657-6592

700 NE Multnomah St
Ste 870
Portland, OR 97232
Phone (503) 238-5559

8555 SW Apple Way
Ste 320
Portland, OR 97225
Phone (503) 430-5762

10260 SW Greenburg Rd
Fl 4
Tigard, OR 97223
Phone (503) 405-9338

333 Commerce St
Ste 700
Nashville, TN 37201
Phone (615) 627-2293

11335 NE 122nd Way
Ste 105
Kirkland, WA 98034
Phone (206) 899-5479

5109 NE 82nd Ave
Ste 215
Vancouver, WA 98662
Phone (832) 840-1604

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1235408048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 SW MACADAM AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393827",
            "telephone_number": "646-342-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 SW MACADAM AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393827",
            "telephone_number": "917-202-5500",
            "fax_number": "917-202-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "MICHAEL",
        "credential": "NP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-22",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "340831",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "201806622NP-PP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61029814",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201806622NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.