MR. KEVIN LEE PETERS (NPI# 1043877103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1043877103 |
Entity Type | Individual |
Full Name | MR. KEVIN LEE PETERS |
Credential | CADC1 |
Practice Address |
20 Ne 10th Ave Portland OR 97232-2916 |
Mailing Address |
1027 E Burnside St Portland OR 97214-1328 |
Practice Telephone | 5032398400 |
Practice Fax Number | 5032398407 |
Mailing Telephone | 5032398400 |
Mailing Fax Number | 5032398407 |
Enumeration Date | 2019-05-23 |
Last Update Date | 2019-05-23 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
101YA0400X | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326525304 | Kevin Patrick Peters | Physician Assistant | 5666 E State St, Rockford, IL 61108-2425 | 2018-07-23 |
1083123038 | Kevin Peters | Nurse Practitioner | 444 N Eola Rd Ste 110, Aurora, IL 60502-9619 | 2017-09-21 |
Street Address |
20 NE 10TH AVE |
City | PORTLAND |
State | OR |
Zip Code | 97232-2916 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639680374 | Amanda Matteo | Counselor | 20 Ne 10th Ave, Portland, OR 97232 | 2017-10-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881293215 | Oregon Change Clinic | Clinic/Center | 650 Ne Holladay Street, Suite 1600, Portland, OR 97232 | 2020-10-17 |
1154969947 | Lori Kristen Miracle | Acupuncturist | Kwan Yin Healing Arts Center East Inc, 3115 Ne Sandy Blvd. Suite 231, Portland, OR 97232 | 2019-12-12 |
1194285411 | Onampai Modina Soondarotok | Student in an Organized Health Care Education/Training Program | Ipp, Oregon Health & Science University, 2214 Lloyd Center, Portland, OR 97232 | 2019-03-22 |
1003399635 | Cathleen Nicole Wenberg | Social Worker | 1839 Ne Couch St, Portland, OR 97232 | 2018-09-10 |
1508350760 | Float North | Acupuncturist | 1617 Ne 17th Ave., Portland, OR 97232 | 2018-06-20 |
1629560719 | Rachael Lee Walters | Doula | 3005 Ne Hoyt St, Portland, OR 97232 | 2018-06-04 |
1225529431 | Jason Sutherland | Social Worker | 707 Ne Couch, Portland, OR 97232 | 2018-05-23 |
1770089245 | Richard Farwell Leman | Family Medicine | 800 Ne Oregon St., Suite 772, Portland, OR 97232 | 2018-04-03 |
1952803413 | Aleksandra Giedowyn Md PC | Family Medicine | 1923 Ne Broadway Street Suite 2, Portland, OR 97232 | 2018-03-01 |
1043755028 | Raolat Ajibade IIi | Adult Companion | 847 N.e 19thave, Portland, OR 97232 | 2016-12-29 |
Find all providers in zip 97232 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477163657 | Kevin Charles Reiser | Counselor | 2318 Ne Martin Luther King Blvd, Portland, OR 97212-3715 | 2020-08-03 |
1881203628 | Beau Curtiss | Counselor | 7916 Se Foster Rd Ste 203, Portland, OR 97206-4289 | 2020-07-28 |
1851916886 | Jonathan Cross | Counselor | 49 Montrose Ave Apt 3, Portland, ME 04103-2442 | 2020-06-16 |
1639703960 | Elizabeth Ann Anderson | Counselor | 1820 Sw Vermont St Ste J, Portland, OR 97219-1945 | 2020-02-25 |
1194356618 | Deforrest Kwesi Jackson | Counselor | 122 Ne 122nd Ave Ste 200, Portland, OR 97230-2103 | 2020-02-03 |
1760012942 | Jesse Decker | Counselor | 7015 N Boston Ave, Portland, OR 97217-5711 | 2020-01-16 |
1740829076 | Ryan Christianson | Counselor | 2707 Ne Flanders St, Portland, OR 97232-3159 | 2020-01-03 |
1083264477 | Kayla Rose Paris | Counselor | 420 Cumberland Ave, Portland, ME 04101-2823 | 2019-09-17 |
1275193260 | Anna Khval | Counselor | 1500 Se 122nd Ave, Portland, OR 97233-1207 | 2019-06-20 |
1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
Find all providers in PORTLAND |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.