PEACEHEALTH NETWORKS ON DEMAND, LLC (NPI# 1386254514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386254514 |
| Entity Type | Organization |
| Organization Name | PEACEHEALTH NETWORKS ON DEMAND, LLC |
| Practice Address |
3872 N Mississippi Ave Portland OR 97227-1161 |
| Mailing Address |
1455 Nw Irving St Ste 600 Portland OR 97209-2277 |
| Practice Telephone | 5039413807 |
| Practice Fax Number | 5039413809 |
| Mailing Telephone | 5039413807 |
| Mailing Fax Number | 5039413809 |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2020-08-03 |
| Authorized Official Name | DR. MALLORY ALYSE KEMPTON-HEIN (PHARMACIST) |
| Authorized Official Telephone | 5039413807 |
| Authorized Official Credential | PHARM D. |
| Is Organization Subpart | Y |
| Parent Organization Name | PEACEHEALTH NETWORKS ON DEMAND, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | SUPERVISING PHYSICIAN DISPENSING OUTLET | 0000008-CS | 01 |
| Other Name | Type Code |
|---|---|
| ZoomCare- Mississippi | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740890268 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 10541 Ne 4th St, Bellevue, WA 98004-5023 | 2020-08-10 |
| 1770193294 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 4555 Stone Way N, Seattle, WA 98103-6647 | 2020-08-10 |
| 1386254811 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 123 Broadway E Ste A, Seattle, WA 98102-5711 | 2020-08-10 |
| 1538779137 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 781 W Columbia Way, Vancouver, WA 98660 | 2020-08-07 |
| 1659981272 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 15911 Westminister Way N., Shoreline, WA 98113 | 2020-08-07 |
| 1154931814 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 6910 Se Milwaukie Ave, Portland, OR 97202-5717 | 2020-08-06 |
| 1841800752 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 517 Union St, Seattle, WA 98101-2308 | 2020-08-05 |
| 1437769320 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 10425 Ne 8th St, Bellevue, WA 98004-4346 | 2020-08-05 |
| 1184234072 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 2038 Nw Market St, Seattle, WA 98107-4012 | 2020-08-05 |
| 1619587482 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 4012 Sw Alaska St, Seattle, WA 98116-4529 | 2020-08-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | PeaceHealth Networks on Demand, LLC | 1115 Se 164th Avenue, Dept. 302, Vancouver, WA 98683 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH NETWORKS ON DEMAND, LLC | 1115 Se 164th Ave Dept 302, Vancouver, WA 98683 |
| Street Address |
3872 N MISSISSIPPI AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1851955975 | Erin Marie Staples | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 | 2019-04-24 |
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1730615071 | Mehran Giblin | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 | 2017-05-05 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| 1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
| 1215390760 | Tanya Marie Woods | Massage Therapist | 3808 N. Williams Ave., Portland, OR 97227 | 2016-04-01 |
| 1033596853 | Eric Allen Martin | Counselor | 2054 N. Vancouver Ave, Portland, OR 97227 | 2015-04-30 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
| Find all providers in zip 97227 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154931814 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 6910 Se Milwaukie Ave, Portland, OR 97202-5717 | 2020-08-06 |
| 1902416175 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 8179 N Lombard St, Portland, OR 97203-3130 | 2020-08-03 |
| 1144830365 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 945 Nw Lovejoy St, Portland, OR 97209-3475 | 2020-08-03 |
| 1174133300 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 7855 Sw Capitol Hwy, Portland, OR 97219-2465 | 2020-08-03 |
| 1407466865 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 3218 Ne Broadway St, Portland, OR 97232-1815 | 2020-07-31 |
| 1437768066 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 2400 E Burnside St, Portland, OR 97214-1752 | 2020-07-29 |
| 1447869060 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 3150 Se Division St, Portland, OR 97202-1172 | 2020-07-29 |
| 1699385401 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 172 Ne Martin Luther King Jr Blvd, Portland, OR 97232-2943 | 2020-08-06 |
| 1821608514 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 607 Ne Grand Ave, Portland, OR 97232-2728 | 2020-08-06 |
| 1043820848 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 202 Nw 13th Ave, Portland, OR 97209-2953 | 2020-08-06 |
| 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.