Peach Skin North Portland Healthcare LLC

Primary specialty

NaturopathTaxonomy code 175F00000X

Legal business name

PEACH SKIN NORTH PORTLAND HEALTHCARE LLC

Practice address

3537 N Williams Ave
Portland, OR 97227-1437

Phone

(971) 413-3207

Fax

(503) 477-8107

NPI assigned

Nov 6, 2018

Last updated

Nov 6, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jaqueline Lopes Brockert, NDNPI 1497230981

Title

Manager/Employee

Phone

(971) 413-3207

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jaqueline Lopes Brockert, ND

  • Naturopath
  • Portland, OR
  • NPI 1497230981
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541462400000",
    "number": "1578031746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3537 N WILLIAMS AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271437",
            "telephone_number": "971-413-3207",
            "fax_number": "503-477-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3537 N WILLIAMS AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271437",
            "telephone_number": "971-413-3207",
            "fax_number": "503-477-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH SKIN NORTH PORTLAND HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-06",
        "status": "A",
        "authorized_official_last_name": "BROCKERT",
        "authorized_official_first_name": "JAQUELINE",
        "authorized_official_middle_name": "LOPES",
        "authorized_official_title_or_position": "MANAGER/EMPLOYEE",
        "authorized_official_telephone_number": "971-413-3207",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Peacehealth Networks on Demand, LLC (ZoomCare-NE Fremont)
• Peacehealth Networks on Demand, LLC (ZoomCare- St. Johns)
• Peacehealth Networks on Demand, LLC (ZoomCare-Downtown Portland)
• Jocelyn Ruby Peacock-Johnson, BS
• Ausa Peacock, LMT
• Brandy Peacock, LMT
• Heather Peacock
• Lisa Peacock, LMFT

• Naturopath in Portland, OR
• Providers in Portland, OR by specialty
• Naturopath in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.