Individual provider · Type 1 NPI

John Kenneth Summerville

Mental Health Counselor · Gresham, OR

NPI number 1710830005 Active

Practice location

360 SW 6th St
Gresham, OR 97080-9475

Call (503) 568-6056 Map

Mailing address

2700 W Powell Blvd Apt 209
Gresham, OR 97030-6569

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1710830005

John Kenneth Summerville's National Provider Identifier is 1710830005, issued on Feb 17, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Gresham, OR. The record was last updated on Feb 17, 2026.