Pendleton Acadmies
Pendleton Acadmies is a healthcare organization registered as Emotionally Disturbed Childrens' Residential Treatment Facility in Pendleton, OR, holding Type 2 (organization) NPI 1417991258 since 2006. The authorized official on file is P. Edvalson, Interim Executive Director.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1417991258 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Pendleton Acadmies |
| Other name | <Unavail> |
| Practice address | 622 AIRPORT RD, Pendleton, OR, 97801 |
| Phone | 5412760057 |
| Fax | 5412761704 |
| Enumeration date | 2006-06-15 |
| Last updated in NPPES | 2008-11-21 |
Authorized official
| Name | P. Edvalson |
|---|---|
| Title | Interim Executive Director |
| Phone | 5419667810 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 385HR2055X | Child Mental Illness Respite Care | Secondary | — | OR |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | Secondary | — | OR |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | Secondary | — | OR |
| 251S00000X | Community/Behavioral Health Agency | Secondary | — | OR |
| 251B00000X | Case Management Agency | Secondary | — | OR |
| 101YM0800X | Mental Health Counselor | Secondary | — | OR |
| 103T00000X | Psychologist | Secondary | — | OR |
| 103TB0200X | Cognitive & Behavioral Psychologist | Secondary | — | OR |
| 323P00000X | Psychiatric Residential Treatment Facility | Secondary | — | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | Secondary | — | — |
| 103TC0700X | Clinical Psychologist | Secondary | — | — |
| 103TC1900X | Counseling Psychologist | Secondary | — | OR |
| 103TC2200X | Clinical Child & Adolescent Psychologist | Secondary | — | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | Primary | — | OR |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 312056 | Medicaid | OR | — |
| S20475 | Medicaid | OR | — |
| 312041 | Medicaid | OR | — |
| 312048 | Medicaid | OR | — |
| 313437 | Medicaid | OR | — |
| PCG023 | Medicaid | OR | — |
| 312064 | Medicaid | OR | — |
| 313205 | Medicaid | OR | — |
| 182229 | Medicaid | OR | — |
| 312040 | Medicaid | OR | — |
Copy-ready billing details
Provider: Pendleton Acadmies NPI: 1417991258 Taxonomy: 322D00000X (Emotionally Disturbed Childrens' Residential Treatment Facility) Address: 622 AIRPORT RD, Pendleton, OR, 97801
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1821284852 | Vince Brunning | Individual | Mental Health Counselor | Pendleton, OR |
| 1720275365 | Diane Cort-Wagner | Individual | Family Nurse Practitioner | Pendleton, OR |
| 1780871236 | Roderick Theis | Individual | Mental Health Counselor | Pendleton, OR |
| 1184811655 | Yvette Wart | Individual | Child & Adolescent Psychiatric/Mental Health Registered Nurse | Pendleton, OR |
| 1245428705 | Leonard Lyons | Individual | Student in an Organized Health Care Education/Training Program | Pendleton, OR |
Verify this record
Cross-check NPI 1417991258 against the authoritative CMS record: view Pendleton Acadmies on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Pendleton Acadmies?
Who is the authorized official for Pendleton Acadmies?
Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2008-11-21.