PEACH SKIN NORTH PORTLAND HEALTHCARE LLC (NPI# 1578031746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578031746 |
| Entity Type | Organization |
| Organization Name | PEACH SKIN NORTH PORTLAND HEALTHCARE LLC |
| Practice Address |
3537 N Williams Ave Portland OR 97227-1437 |
| Practice Telephone | 9714133207 |
| Practice Fax Number | 5034778107 |
| Mailing Telephone | 9714133207 |
| Mailing Fax Number | 5034778107 |
| Enumeration Date | 2018-11-06 |
| Last Update Date | 2018-11-06 |
| Authorized Official Name | DR. JAQUELINE LOPES BROCKERT (MANAGER/EMPLOYEE) |
| Authorized Official Telephone | 9714133207 |
| Authorized Official Credential | ND |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175F00000X | Naturopath | Other Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PEACH SKIN NORTH PORTLAND HEALTHCARE LLC | 3537 N Williams Ave Suite 102, Portland, OR 97227 |
| Street Address |
3537 N WILLIAMS AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
| 1508429077 | Nancy Theodora Leonhardt | Counselor | 3537 N Williams Ave, Portland, OR 97227-1437 | 2019-04-19 |
| 1710443114 | Grady Clemence Nesbitt | Acupuncturist | 3537 N Williams Ave, Portland, OR 97227-1437 | 2019-02-11 |
| 1477038941 | Halcyon Medical LLC | Clinic/Center | 3537 N Williams Ave, Portland, OR 97227-1437 | 2018-10-01 |
| 1194235994 | Erica Danielle Grossman | Counselor | 3537 N Williams Ave, Portland, OR 97227-1437 | 2017-10-05 |
| 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 |
| 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 |
| 1891101671 | Shushaun Badalian | Nurse Practitioner | 406 North Beech Street, Portland, OR 97227 | 2014-07-01 |
| Find all providers in zip 97227 | ||||
| Taxonomy Code | 175F00000X |
| Grouping | Other Service Providers |
| Classification | Naturopath |
| Diagnoses, treats, and cares for patients, using system of practice that bases treatment of physiological functions and abnormal conditions on natural laws governing human body: Utilizes physiological, psychological, and mechanical methods, such as air, water, light, heat, earth, phototherapy, food and herb therapy, psychotherapy, electrotherapy, physiotherapy, minor and orificial surgery, mechanotherapy, naturopathic corrections and manipulation, and natural methods or modalities, together with natural medicines, natural processed foods, and herbs and nature's remedies. Excludes major surgery, therapeutic use of x ray and radium, and use of drugs, except those assimilable substances containing elements or compounds which are components of body tissues and are physiologically compatible to body processes for maintenance of life. |
| Notes: Source: The Federal Dictionary of Occupational Titles, U.S. Department of Labor, Washington, D.C., section #079, 101-014 [7/1/2007: definition changed, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070066 | Jennifer Ann Hampton | Naturopath | 8375 Sw Beaverton Hillsdale Hwy Ste A, Portland, OR 97225-2252 | 2020-10-16 |
| 1376140160 | Casey Rae Rohrbeck | Naturopath | 5020 Ne 32nd Ave Apt 4, Portland, OR 97211-6960 | 2020-10-05 |
| 1366049314 | Jenna Halbert | Naturopath | 333 Ne Russell St Ste 207, Portland, OR 97212-3763 | 2020-10-02 |
| 1679189252 | Hannah Rikoon | Naturopath | 49 S Porter St, Portland, OR 97201-4873 | 2020-09-19 |
| 1710593306 | Charlotte Nowack | Naturopath | 5331 S Macadam Ave Ste 380, Portland, OR 97239-3879 | 2020-09-18 |
| 1043824964 | Pc Health, LLC | Naturopath | 6519 N Vancouver Ave Apt C, Portland, OR 97217-1954 | 2020-09-08 |
| 1821602673 | Stephanie Joy Vickers | Naturopath | 4510 Sw Valona Way, Portland, OR 97219-6827 | 2020-08-31 |
| 1700496957 | Dr. Karen Cureton Nd, Lac | Naturopath | 4818 Se Naef Rd, Portland, OR 97267-4037 | 2020-08-03 |
| 1679182992 | Andrew Wojciechowski | Naturopath | 2701 Nw Vaughn St Ste 424, Portland, OR 97210-5362 | 2020-07-23 |
| 1568082972 | Tristian Rowe | Naturopath | 8407 Sw 35th Ave, Portland, OR 97219-3831 | 2020-04-26 |
| 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.