Provider Demographics
NPI:1427217348
Name:PEPPERWOOD, PAIGE (EDS)
Entity type:Individual
Prefix:MS
First Name:PAIGE
Middle Name:
Last Name:PEPPERWOOD
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:GOWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 N DIXON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1876
Mailing Address - Country:US
Mailing Address - Phone:503-916-6250
Mailing Address - Fax:503-916-2608
Practice Address - Street 1:501 N DIXON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1876
Practice Address - Country:US
Practice Address - Phone:503-916-6250
Practice Address - Fax:503-916-2608
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR143074103T00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health