Individual provider Active NPI

Michelle So-Patzer Wyman

  • Registered Nurse
  • Portland, OR
National Provider Identifier
1790467868
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95153554 Issued in CA
Practice address
707 SW Washington St Ste 700
Portland, OR 97205-3523
Phone
(503) 299-9906
NPI assigned
Aug 7, 2023
Last updated
Apr 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95153554 CA Primary

Addresses

Primary practice location

707 SW Washington St Ste 700
Portland, OR 97205-3523

Mailing address

13743 NE 30TH Ave
Vancouver, WA 98686-4334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241219003832 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890222467 Reassigns benefits to 1 organization
I20241226002383 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890222467 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oregon Anesthesiology Group PCGroup PAC ID 3476451659, 239 clinicians
Anesthesia Associates Northwest LLCGroup PAC ID 7618908484, 80 clinicians

Practice addresses (Care Compare)

1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 299-9906

1330 Commercial St SE
Salem, OR 97302-4206
Phone (503) 763-1973

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone (360) 487-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95153554CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Anesthesiology Group PC CurrentSince Oct 31, 2024 Accepting new patients

Locations

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

707 SW Washington St
Ste 700
Portland, OR 97205

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1790467868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13743 NE 30TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986864334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SW WASHINGTON ST STE 700",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972053523",
            "telephone_number": "503-299-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYMAN",
        "first_name": "MICHELLE",
        "middle_name": "SO-PATZER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95153554",
            "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 Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.