Individual
MICHELLE JENNIFER SUMIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PWS
Contact information
Practice address
3636 NE BROADWAY ST, PORTLAND, OR 97232-1823
(503) 548-0346
(503) 307-7775
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(971) 217-9008
(971) 260-0355
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
116295
OR
Other
Enumeration date
02/26/2026
Last updated
02/26/2026
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