Active NPI
Kylee M Peterson LLC
- Community/Behavioral Health Agency
- Beaverton, OR
National Provider Identifier
1710897715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- KYLEE M PETERSON LLC
- Practice address
- 12785 SW Percheron LN
Beaverton, OR 97008-8123 - Phone
- (503) 208-5223
- NPI assigned
- Sep 10, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kylee Peterson, PSYD
- Title
- Clinical Psychologist
- Phone
- (503) 208-5223
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
12785 SW Percheron LN
Beaverton, OR 97008-8123
Mailing address
12785 SW Percheron LN
Beaverton, OR 97008-8123
Phone (503) 208-5223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788998400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788998400000",
"number": "1710897715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12785 SW PERCHERON LN",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970088123",
"telephone_number": "503-208-5223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12785 SW PERCHERON LN",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970088123",
"telephone_number": "503-208-5223"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KYLEE M PETERSON LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-10",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A",
"authorized_official_last_name": "PETERSON",
"authorized_official_first_name": "KYLEE",
"authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
"authorized_official_telephone_number": "503-208-5223",
"authorized_official_credential": "PSYD"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.