Pacificsource Pace, LLC
PACE Provider Organization · Springfield, OR
Practice location
555 International Way Ste B104Springfield, OR 97477-6013
- Phone
- (458) 544-0400
NPI record
- NPI
- 1104787704
- Entity type
- Organization (Type 2)
- Enumeration date
- November 21, 2025
- Last updated
- July 16, 2026
- Certified
- July 16, 2026
- Organization subpart
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| PACE Provider Organization Primary | 251T00000X |
— | — |
Authorized official
- Name
- Kristin Kernutt, JD
- Title
- Chief Legal Counsel
- Phone
- (541) 225-1967
About Pacificsource Pace, LLC
Pacificsource Pace, LLC is a healthcare organization registered in the NPI registry with the primary taxonomy PACE Provider Organization (code 251T00000X). The practice location is 555 International Way Ste B104, Springfield, OR 97477-6013. The NPI number 1104787704 was assigned on November 21, 2025 and the record was last updated on July 16, 2026.
The authorized official for this organization is Kristin Kernutt, JD, Chief Legal Counsel.
Frequently asked questions
What is the NPI number of Pacificsource Pace, LLC?
The NPI number is 1104787704.
What is the phone number of Pacificsource Pace, LLC?
The phone number listed for the practice location is (458) 544-0400.
Where is Pacificsource Pace, LLC located?
555 International Way Ste B104, Springfield, OR 97477-6013.
What is the taxonomy code for Pacificsource Pace, LLC?
The primary taxonomy code is 251T00000X – PACE Provider Organization.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.