PEGGY ANN BRADLEY-PEARSON (NPI# 1114106598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114106598 |
| Entity Type | Individual |
| Full Name | PEGGY ANN BRADLEY-PEARSON |
| Credential | ANP |
| Practice Address |
3500 N Interstate Ave Portland OR 97227-1196 |
| Mailing Address |
14653 Nw Dawnwood Dr Portland OR 97229-1563 |
| Practice Telephone | 5032495511 |
| Mailing Telephone | 5036171405 |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2007-11-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
200550062NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3500 N INTERSTATE AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1196 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972542009 | Gregory J Davenport | Physician Assistant | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2006-06-05 |
| 1922513910 | Emily A Vanlaningham | Social Worker | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2017-12-12 |
| 1770026023 | Debra Viegas | Pharmacist | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2016-11-18 |
| 1619419942 | Stephen Glenn | Pharmacist | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2016-11-17 |
| 1467903013 | Kaiser Foundation Health Plan of The Northwest | General Practice | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2016-10-19 |
| 1871043422 | Robbi Shannon | Pharmacist | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2016-10-06 |
| 1801125521 | Lucie Krenek | Orthopaedic Surgery | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2009-12-08 |
| 1366779019 | Diana Muresan | Pulmonary Function Technologist | 3500 N Interstate Ave, Portland, OR 97227 | 2009-11-17 |
| 1811141880 | Kaiser Foundation Health Plan of The Northwest | Clinical Medical Laboratory | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2008-11-04 |
| 1255581385 | Sheila Ann Jiroch | Respiratory Therapist, Registered | 3500 N Interstate Ave, Portland, OR 97227-1196 | 2008-09-25 |
| Find all providers in the same location | ||||
| 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 | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184257115 | Joanna Rae Farrell | Nurse Practitioner | 1650 Ne 32nd Ave Apt 425, Portland, OR 97232-3455 | 2020-02-18 |
| 1497309652 | Dorothy Elizabeth Zirkle | Nurse Practitioner | 66 Bramhall St Ste Gi, Portland, ME 04102-3344 | 2019-07-26 |
| 1023590841 | Healthy At Home LLC | Nurse Practitioner | 3910 Ne 99th Ave, Portland, OR 97220-3620 | 2018-08-29 |
| 1437648946 | Stephanie Michele Johnson | Nurse Practitioner | 3560 Se 79th Ave, Portland, OR 97206-2372 | 2018-05-09 |
| 1801266119 | Daniel Dominic Eric Roa | Nurse Practitioner | 5316 N Greeley Ave, Portland, OR 97217-4113 | 2015-09-29 |
| 1154694941 | Donald Upton | Nurse Practitioner | 6959 N Fenwick Ave, Portland, OR 97217-5305 | 2012-02-09 |
| 1497073936 | Jeffrey Grimm | Nurse Practitioner | 1741 Nw 24th Ave, Portland, OR 97210 | 2010-05-07 |
| 1548469869 | Ashlyn J Cross | Nurse Practitioner | Department of Dermatology 3303 Bond Ave., Portland, OR 97239-4501 | 2007-07-17 |
| 1326256959 | Mary Thompson Pierce | Nurse Practitioner | 1750 Nw Naito Parkway, Suite 100, Portland, OR 97209-2533 | 2007-05-18 |
| 1669595237 | Shannon Marie Gwartney | Nurse Practitioner | 808 Sw 15th Ave., Portland, OR 97205 | 2007-04-09 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on PEGGY ANN BRADLEY-PEARSON.
| 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.