OrganizationActive
Pacificsource Pace, LLC
NPI 1104787704 · PACE Provider Organization · Springfield, OR
Pacificsource Pace, LLC is a PACE Provider Organization organization in Springfield, OR (NPI 1104787704).
Provider details
- NPI number
- 1104787704
- Entity type
- Organization
- Primary specialty
- PACE Provider OrganizationAgencies
- Organization subpart
- No
- Authorized official
- Kristin Kernutt, Chief Legal Counsel(541) 225-1967
Specialties & taxonomies
Agencies
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
555 International Way Ste B104
Springfield, OR 97477-6013
Phone: (425) 214-2526
Street-level locationGet directions
Mailing address
555 International Way Ste B104
Springfield, OR 97477-6013
Registry dates
- Enumerated
- 2025-11-21
- Last updated
- 2026-04-27
- Certified
- 2026-04-27
Frequently asked questions
- What is Pacificsource Pace, LLC's NPI number?
- Pacificsource Pace, LLC's National Provider Identifier (NPI) is 1104787704, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pacificsource Pace, LLC?
- Pacificsource Pace, LLC is classified in the NPPES registry as PACE Provider Organization (Agencies).
- Where is Pacificsource Pace, LLC located?
- Pacificsource Pace, LLC's practice location on file with NPPES is 555 International Way Ste B104, Springfield, OR 97477-6013.
- What is Pacificsource Pace, LLC's phone number?
- The practice phone number listed in the NPPES registry for Pacificsource Pace, LLC is (425) 214-2526.
- Who is the authorized official for Pacificsource Pace, LLC?
- The authorized official listed on Pacificsource Pace, LLC's NPPES record is Kristin Kernutt, Chief Legal Counsel. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pacificsource Pace, LLC's NPI active?
- Yes — Pacificsource Pace, LLC's NPI (1104787704) is active in the NPPES registry as of the last update on 2026-04-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.