KELLY PETERSON (NPI# 1710016563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710016563 |
| Entity Type | Individual |
| Full Name | KELLY PETERSON |
| Credential | LPC |
| Practice Address |
5240 Ne Elam Young Pkwy Ste 100 Hillsboro OR 97124 |
| Mailing Address |
58646 Mcnulty Way Saint Helens OR 97051-6210 |
| Practice Telephone | 5038464555 |
| Mailing Telephone | 5033975211 |
| Mailing Fax Number | 5033975373 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2018-05-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
C1743 | OR | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 998 Library Ct, Oregon City, OR 970454041 | 5036558401 | 5036558429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013450907 | Kelly Rose Peterson | Physical Therapist | 1190 Baker St Ste 105, Costa Mesa, CA 92626-4105 | 2016-11-23 |
| 1326437120 | Kelly Leigh Peterson | Nurse Practitioner | 2200 Childrens Way Monroe Carell Jr, Doctor's Office Tower, 7th Floor, Suite 7100, Nashville, TN 37232-0001 | 2015-01-16 |
| 1336424027 | Kelly Rae Peterson | Nurse Anesthetist, Certified Registered | 9803 Vagabond Ln N, Maple Grove, MN 55311-1364 | 2011-10-13 |
| 1235413758 | Kelly Suzanne Peterson | Naturopath | 638 Fulton St W Suite B, Grand Rapids, MI 49504 | 2011-10-03 |
| 1558399261 | Kelly B Peterson | Dentist | 5100 Grove St, Ste B, Marysville, WA 98270-4492 | 2006-06-29 |
| 1639787872 | Kelly Peterson | Military Health Care Provider | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-07-14 |
| 1255965208 | Kelly A Peterson | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-02-28 |
| 1639720014 | Kelly Ann Peterson | Counselor | 20288 Highway 15 N Ste 100, Hutchinson, MN 55350-5685 | 2019-09-26 |
| 1164087730 | Kelly Peterson | Registered Nurse | 410 W 10th Ave, Columbus, OH 43210-1240 | 2019-05-08 |
| 1366923963 | Kelly Peterson | Counselor | 205 Burlington Rd, Bedford, MA 01730-1406 | 2018-08-22 |
| Street Address |
5240 NE ELAM YOUNG PKWY STE 100 |
| City | HILLSBORO |
| State | OR |
| Zip Code | 97124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831653500 | Jennifer Bateman | Peer Specialist | 5240 Ne Elam Young Pkwy Ste 100, Hillsboro, OR 97124-6438 | 2019-01-28 |
| 1952893141 | Georgia Lopez | Counselor | 5240 Ne Elam Young Pkwy Ste 100, Hillsboro, OR 97124-6438 | 2018-06-04 |
| 1508253139 | Crystal Ann Fisher | Counselor | 5240 Ne Elam Young Pkwy Ste 100, Hillsboro, OR 97124 | 2015-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538705322 | Pamela Anne Martin | Registered Nurse | 2875 Nw Stucki Pl, Hillsboro, OR 97124 | 2019-11-27 |
| 1912548892 | Donnia Mae Schwarz | Behavior Technician | 5121 Ne Elam Young Pkwy, Hillsboro, OR 97124 | 2019-10-02 |
| 1609305036 | Catherine Lydon | Registered Nurse | 18650 Nw Cornell Road Suite 220, Hillsboro, OR 97124 | 2017-06-08 |
| 1376092163 | Michael Han | Pharmacist | 2875 Nw Stucki Avenue/, Hillsboro, OR 97124 | 2016-09-22 |
| 1760868459 | Voices Set Free | Community/Behavioral Health | 254 North 1st Ave., Hillsboro, OR 97124 | 2015-08-04 |
| 1871980151 | Kevin Kar Fai Cheng | Dentist | 7206 Ne Cornell Rd, Hillsboro, OR 97124 | 2015-04-23 |
| 1336530047 | Maegan Lee Mcglone | Behavioral Analyst | 5801 Ne Cornelius Pass Rd, Hillsboro, OR 97124 | 2015-02-17 |
| 1588095772 | Hillsboro Modern Dentistry, PC | Dentist | 2790 Nw 188th Avenue, Suite A, Hillsboro, OR 97124 | 2013-12-12 |
| 1275977043 | Dana Hazell | Massage Therapist | 5035 Ne Elam Young Parkway, Suite 500, Hillsboro, OR 97124 | 2013-04-24 |
| 1679816771 | Candice May Doyle | Massage Therapist | 5215 Ne Elam Young Park Way, Suite A, Hillsboro, OR 97124 | 2013-03-27 |
| Find all providers in zip 97124 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730700725 | Cornerstone, LLC | Counselor | 2800 Us Highway 62, Hillsboro, OH 45133-1606 | 2020-04-30 |
| 1790320224 | Gema Hernandez | Counselor | 21185 Nw Evergreen Pkwy Ste 105, Hillsboro, OR 97124-7127 | 2019-11-07 |
| 1538634902 | Elizabeth Dyan Ficker | Counselor | 3000 Ne Stucki Ave Ste 230, Hillsboro, OR 97124-7328 | 2018-10-11 |
| 1669969648 | Denija Delic | Counselor | 126 E Elm St, Hillsboro, TX 76645-3321 | 2018-04-16 |
| 1760998785 | Karianne Lowe | Counselor | 1547 Se 74th Ave, Hillsboro, OR 97123-6190 | 2017-12-28 |
| 1679010300 | Julie Larkin | Counselor | 233 E Main St Ste 214, Hillsboro, OR 97123-4066 | 2017-01-19 |
| 1144655705 | Tony Via | Counselor | 211 E Elm St, Hillsboro, TX 76645-3322 | 2013-09-13 |
| 1275871337 | Karen Ann Debolt | Counselor | 5234 Ne Farmcrest St, Hillsboro, OR 97124-6065 | 2013-01-24 |
| 1134495807 | Molly Oberweiser | Counselor | 155 N. First Ave., Ms #70, Hillsboro, OR 97124-3072 | 2012-03-28 |
| 1952685133 | Paulie Tietz | Counselor | 6701 Ne Campus Dr, Hillsboro, OR 97124-5500 | 2011-10-05 |
| Find all providers in HILLSBORO | ||||
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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.