BRANDY PEACOCK (NPI# 1295204436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295204436 |
| Entity Type | Individual |
| Full Name | BRANDY PEACOCK |
| Credential | LMT |
| Practice Address |
2121 W Burnside St Portland OR 97210-3519 |
| Mailing Address |
9512 Sw 47th Ave Portland OR 97219-5243 |
| Practice Telephone | 5034328348 |
| Mailing Telephone | 5039643556 |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2018-11-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2121 W Burnside St, Portland, OR 972103519 | 5034328348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912130683 | Brandy R Peacock | Nurse Practitioner | 200 Corporate Blvd, Suite 201, Lafayette, LA 70508-3870 | 2009-08-28 |
| Street Address |
2121 W BURNSIDE ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97210-3519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295270296 | Bio Foot Reflexology and Massage Center | Reflexologist | 2121 W Burnside St, Portland, OR 97210-3519 | 2016-12-29 |
| 1992340236 | Ren Theodore Rain | Massage Therapist | 2121 W Burnside St, Portland, OR 97210-3519 | 2019-11-11 |
| 1568025153 | Kara Noelle Cooper | Massage Therapist | 2121 W Burnside St, Portland, OR 97210-3519 | 2019-04-18 |
| 1134631138 | Huade Zeng | Massage Therapist | 2121 W Burnside St, Portland, OR 97210-3519 | 2017-10-30 |
| 1427569052 | Jonathan Irvin | Acupuncturist | 2121 W Burnside St, Portland, OR 97210-3519 | 2017-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679109086 | Joseph Francolino | Massage Therapist | 2174 Nw Davis Street, Apartment 105, Portland, OR 97210 | 2020-03-17 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1649769480 | Dipesh Patel | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Ave. Legacy Clinic Good Samaritan, Portland, OR 97210 | 2018-05-08 |
| 1760987234 | Meghan Teague | Student in an Organized Health Care Education/Training Program | Legacy Good Samaritan Medical Center- Gme, 1015 Nw 22nd Ave, Portland, OR 97210 | 2018-03-27 |
| 1205349172 | Paul M Storm | Acupuncturist | 1708 Nw 25th Ave. Apt. #6, Portland, OR 97210 | 2017-11-14 |
| 1740703750 | Audra K Berning | Massage Therapist | 2122 Nw Quimby, Root Whole Body, Portland, OR 97210 | 2017-07-21 |
| 1720539810 | Anna-marie Elizabeth Wood | Audiologist | 2222 Nw Lovejoy St Ste 662, Portland, OR 97210 | 2016-10-24 |
| 1659829836 | H&s Pearl, LLC | Massage Therapist | 25 Nw 23rd Pl, Suite 7, Portland, OR 97210 | 2016-09-15 |
| 1255785796 | Cortez Natural Medicine, Inc. | Acupuncturist | 2230 Nw Pettygove Street, Unit 130, Portland, OR 97210 | 2016-04-21 |
| 1932563616 | Vincent Chen | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Avenue, Legacy Clinic Good Samaritan, Portland, OR 97210 | 2016-04-08 |
| Find all providers in zip 97210 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013712 | Gabriel Henriques | Massage Therapist | 805 Se Peacock Ln, Portland, OR 97214-3278 | 2020-11-07 |
| 1871193490 | Heather R Anderson | Massage Therapist | 1646 Se Tenino St, Portland, OR 97202-6713 | 2020-11-01 |
| 1205435716 | Michella Onnis | Massage Therapist | 2410 Se 10th Ave, Portland, OR 97214-4624 | 2020-10-26 |
| 1063019479 | Kevin Thomas Ryan | Massage Therapist | 2220 Nw Front Ave Apt 316, Portland, OR 97209-1998 | 2020-10-08 |
| 1497352389 | Nikki Nesta | Massage Therapist | 7849 Se Monroe St, Portland, OR 97222-1158 | 2020-10-05 |
| 1518574953 | Jessica Rose Hobbs | Massage Therapist | 1515 Sw Jefferson St Apt 15, Portland, OR 97201-6064 | 2020-09-29 |
| 1295340057 | Shane Dylan Adair | Massage Therapist | 2934 Se Stephens St, Portland, OR 97214-4960 | 2020-09-09 |
| 1518579416 | Scott Schwartz | Massage Therapist | 4425 S Corbett Ave, Portland, OR 97239-4260 | 2020-08-20 |
| 1134747074 | Katrina Hubbard | Massage Therapist | 1515 Sw 5th Ave, Portland, OR 97201-5406 | 2020-07-07 |
| 1407474539 | Kirstin Hoops | Massage Therapist | 1531 N Webster St, Portland, OR 97217-3752 | 2020-07-06 |
| 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.