Cynthia Jean Peck

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

015428 Issued in OR

Practice address

15850 NW Central Dr
Portland, OR 97229-1101

Phone

(503) 506-2426

NPI assigned

Aug 17, 2023

Sex

Female

Sole proprietor

No

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)

Enrolled

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1780467100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16048 NW CENTINE LN",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972291129",
            "telephone_number": "503-804-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15850 NW CENTRAL DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972291101",
            "telephone_number": "503-506-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "CYNTHIA",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "015428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Paul Pebler, CADC
• Mark Pechovnik, LCSW
• Gabriel Adrian Peck-Frame, DO
• Amy Samantha Peck
• Ashley Peck
• Elizabeth Joann Peck, DPT
• Gretli Peck, MSW
• James J Peck, M.D.
• Julia Grace Peck, BA
• Regina Peck

• Speech-Language Pathologist in Portland, OR
• Providers in Portland, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.