Sara Cassandra Peddicord

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

9123 SE Saint Helens St Ste 275C
Clackamas, OR 97015-6858

Phone

(541) 316-8234

NPI assigned

Feb 7, 2020

Last updated

Feb 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1649802737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 4TH ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452304",
            "telephone_number": "210-325-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9123 SE SAINT HELENS ST STE 275C",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156858",
            "telephone_number": "541-316-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDDICORD",
        "first_name": "SARA",
        "middle_name": "CASSANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PDX Allergy LLC
• PDX Sleep Solutions, LLC
• Peacehealth Networks on Demand, LLC (ZoomCare- Clackamas)
• Larah Pearson
• Tracy Jeanne Peck, MD
• Michael Joseph Peizner, PHARMACIST
• Rachel Lynn Pena, RDH
• Zachary G Pena, M.D.
• Laurel Perilli, PT
• Kyle Pernula, PA-C

• Counselor in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.