NPIMap

Organization Active NPI

Peacehealth Networks on Demand, LLC

  • Non-Pharmacy Dispensing Site
  • Lake Oswego, OR
National Provider Identifier
1962012955
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
PEACEHEALTH NETWORKS ON DEMAND, LLC
Practice address
111 A Ave
Lake Oswego, OR 97034-3116
Phone
(503) 684-8252
Fax
(833) 450-7644
NPI assigned
Aug 4, 2020
Organization subpart
Yes
Parent organization
PEACEHEALTH NETWORKS ON DEMAND, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Authorized official

Name
Mallory Alyse Kempton-Hein, PHARM D
Title
Pharmacist
Phone
(503) 684-8252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

111 A Ave
Lake Oswego, OR 97034-3116

Mailing address

11958 SW Garden PL
Tigard, OR 97223-8248
Phone (503) 684-8252

Other identifiers 1

IdentifierTypeStateIssuer
0000063OtherORDISPENSING PRACTITIONER DRUG OUTLET

Other names 1

  • ZoomCare-Lake Oswego Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Peacehealth Networks62 organizations share this tax ID, including this one
Part of
Peacehealth Networks

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

111 A Ave
Lake Oswego, OR 97034

NPI Registry JSON

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1962012955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11958 SW GARDEN PL",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238248",
            "telephone_number": "503-684-8252",
            "fax_number": "866-859-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 A AVE",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970343116",
            "telephone_number": "503-684-8252",
            "fax_number": "833-450-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEHEALTH NETWORKS ON DEMAND, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEACEHEALTH NETWORKS ON DEMAND, LLC",
        "enumeration_date": "2020-08-04",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "KEMPTON-HEIN",
        "authorized_official_first_name": "MALLORY",
        "authorized_official_middle_name": "ALYSE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "503-684-8252",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DISPENSING PRACTITIONER DRUG OUTLET",
            "identifier": "0000063",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ZoomCare-Lake Oswego",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ZoomCare-Lake Oswego",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.