Maxwell Lee Summerlin

Primary specialty

Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X

License

2025197 Issued in OR

Practice address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Phone

(503) 494-8311

NPI assigned

Mar 24, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1417533886",
    "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"
        },
        {
            "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": "503-494-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERLIN",
        "first_name": "MAXWELL",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "OR",
            "license": "2025197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John D Summer, DDS
• Lauren Summer
• Lily Barbara Summer, PA-C
• Andrew Lee Summerer, PSYD
• Whitney Summerer, LPC ASSOCIATE
• Summerplace Assisted Living LLC
• Summerplace Community Healthcare LLC
• Summers Point Therapy LLC
• Caren Elizabeth Summers-Nomura, MS
• Aaron Beaugh Summers, DNP-FNP

• Clinical Genetics (M.D.) Physician in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Genetics (M.D.) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.