Individual provider Active NPI

Tiffany Sommer, CNM, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1619036761
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201601260NP-PP Issued in OR
Practice address
700 NE Multnomah St Ste 275
Portland, OR 97232-4103
Phone
(503) 729-1380
NPI assigned
Dec 6, 2006
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201601260NP-PP OR Primary
Advanced Practice Midwife 367A00000X 201601260NP-PP OR

Addresses

Primary practice location

700 NE Multnomah St Ste 275
Portland, OR 97232-4103

Mailing address

700 NE Multnomah St Ste 275
Portland, OR 97232-4103
Phone (503) 729-1380

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241108000107 OR Practitioner - Nurse Practitioner 8628078664 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201601260NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Health & Wellness LLC Psychiatric/Mental Health CurrentSince Oct 15, 2024 Accepting new patients

Locations

700 NE Multnomah St
Ste 275
Portland, OR 97232
Phone (503) 729-1380

Organizations & group practices 1

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1619036761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE MULTNOMAH ST STE 275",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972324103",
            "telephone_number": "503-729-1380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE MULTNOMAH ST STE 275",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972324103",
            "telephone_number": "503-729-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMMER",
        "first_name": "TIFFANY",
        "credential": "CNM, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201601260NP-PP",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "201601260NP-PP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.