Organization
OREGON LIGHTNING YOUTH INITIATIVE INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN NICOLE PEELER (DIRECTOR OF ADMINISTRATION)
(214) 972-7781
Entity
Organization
Contact information
Practice address
616 SW EVERGREEN AVE, REDMOND, OR 97756-2240
(971) 227-6815
Mailing address
521 SW 6TH ST STE 100, REDMOND, OR 97756-2702
(971) 227-6815
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/25/2025
Last updated
11/25/2025
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