Ketrick Pendergrass
NPI 1992412035 · Addiction (Substance Use Disorder) Counselor · Coburg, OR
Ketrick Pendergrass is a Addiction (Substance Use Disorder) Counselor provider in Coburg, OR (NPI 1992412035).
Provider details
- NPI number
- 1992412035
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
83% 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
Mailing address
Registry dates
- Enumerated
- 2022-10-28
- Last updated
- 2022-10-28
- Certified
- 2022-10-26
Frequently asked questions
- What is Ketrick Pendergrass's NPI number?
- Ketrick Pendergrass's National Provider Identifier (NPI) is 1992412035, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ketrick Pendergrass's specialty?
- Ketrick Pendergrass is listed in the NPPES registry with a primary specialty of Addiction (Substance Use Disorder) Counselor (Behavioral Health & Social Service Providers).
- Where is Ketrick Pendergrass located?
- Ketrick Pendergrass's practice location on file with NPPES is 1 Serenity Ln, Coburg, OR 97408-9350.
- What is Ketrick Pendergrass's phone number?
- The practice phone number listed in the NPPES registry for Ketrick Pendergrass is (541) 687-1110.
- Is Ketrick Pendergrass's NPI active?
- Yes — Ketrick Pendergrass's NPI (1992412035) is active in the NPPES registry as of the last update on 2022-10-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.