IndividualActive
Maxwell Summerlin
NPI 1417533886 · Clinical Genetics (M.D.) Physician · Portland, OR
Provider details
- NPI number
- 1417533886
- Entity type
- Individual
- Primary specialty
- Clinical Genetics (M.D.) PhysicianAllopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- No
- License
- 2025197 (OR)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3181 Sw Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 494-8311
Approximate (ZIP-level) locationGet directions
Mailing address
3181 Sw Sam Jackson Park Rd
Portland, OR 97239-3011
Registry dates
- Enumerated
- 2021-03-24
- Last updated
- 2026-04-30
- Certified
- 2026-04-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.