Michelle Jennifer Sumida, PWS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

116295 Issued in OR

Practice address

3636 NE Broadway St
Portland, OR 97232-1823

Phone

(503) 548-0346

Fax

(503) 307-7775

NPI assigned

Feb 26, 2026

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Native American Rehabilitation Assoc Inc

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1619106945
  NPD (past)
• Native American Rehabilitation Assoc Inc

  • Federally Qualified Health Center (FQHC)
  • Gresham, OR
  • NPI 1942747761
  NPD (past)

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

{
    "created_epoch": "1772064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1881548683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SE CARUTHERS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144502",
            "telephone_number": "971-217-9008",
            "fax_number": "971-260-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321823",
            "telephone_number": "503-548-0346",
            "fax_number": "503-307-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMIDA",
        "first_name": "MICHELLE",
        "middle_name": "JENNIFER",
        "credential": "PWS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-26",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "116295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serena D Sullivan
• Stephen Sullivan
• Tessandrea Sullivan
• Bariisaa Kedir Sultan
• Gary L Sultany, MD
• Jeffrey Scott Summer, MSW
• John D Summer, DDS
• Lauren Summer
• Lily Barbara Summer, PA-C
• Andrew Lee Summerer, PSYD

• Peer Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.