NPIMap

Organization Active NPI

Oregon Lightning Youth Initiative Incorporated

  • Community Health Worker
  • Redmond, OR
National Provider Identifier
1750243176
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Legal business name
OREGON LIGHTNING YOUTH INITIATIVE INCORPORATED
Practice address
616 SW Evergreen Ave
Redmond, OR 97756-2240
Phone
(971) 227-6815
NPI assigned
Nov 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Authorized official

Name
Gwendolyn Nicole Peeler
Title
Director of Administration
Phone
(214) 972-7781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X Primary

Addresses

Primary practice location

616 SW Evergreen Ave
Redmond, OR 97756-2240

Mailing address

521 SW 6TH St Ste 100
Redmond, OR 97756-2702
Phone (971) 227-6815

National Provider Directory

National Provider Directory

Locations

616 SW Evergreen Ave
Redmond, OR 97756
Phone (971) 227-6815

521 SW 6th St
Ste 100
Redmond, OR 97756

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1764028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1750243176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 SW 6TH ST STE 100",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562702",
            "telephone_number": "971-227-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 SW EVERGREEN AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562240",
            "telephone_number": "971-227-6815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON LIGHTNING YOUTH INITIATIVE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-25",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "PEELER",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "214-972-7781"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.