WILD PELORIA, LLC
NPI 1033902382
Counselor - Mental Health in Clackamas, OR

Q: What is Wild Peloria, LLC's NPI number?

The NPI number for Wild Peloria, LLC is 1033902382. It was assigned to this organization in the NPPES registry on May 28, 2025.

Q: What is Wild Peloria, LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Wild Peloria, LLC was last updated on October 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 28, 2025

12035 SE GRAND VISTA DR, CLACKAMAS, OR 97015(512) 966-4440 Get Directions Write a Review

NPPES record last updated: October 29, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Wild Peloria, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILD PELORIA, LLC (NPI 1033902382) is a healthcare organization registered as a mental health in Clackamas, Oregon and active in the NPI registry since May 2025. The organization lists Jamie Watson, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1033902382

Entity TypeOrganization

Primary Taxonomy101YM0800X

Legal Business NameWILD PELORIA, LLC

Location Address12035 SE GRAND VISTA DRClackamas, OR 97015-8272

Mailing Address12035 Se Grand Vista DrClackamas, OR 97015-8272 · (512) 966-4440

Phone(512) 966-4440

Organization SubpartNo

Authorized OfficialJamie WatsonClinical Director · (512) 966-4440

Enumeration DateMay 28, 2025

Last NPPES UpdateOctober 29, 2025

NPPES CertifiedOctober 29, 2025

✔ NPI 1033902382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedMarriage & Family TherapistTaxonomy 106H00000X

12035 SE GRAND VISTA DR, Clackamas, OR 97015

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wild Peloria, LLC's NPI number?

The NPI number for Wild Peloria, LLC is 1033902382. It was assigned to this organization in the NPPES registry on May 28, 2025.

Where is Wild Peloria, LLC located?

Wild Peloria, LLC is located at 12035 SE Grand Vista Dr, Clackamas, OR 97015. The listed phone number is (512) 966-4440.

What is Wild Peloria, LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

What insurance does Wild Peloria, LLC accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Wild Peloria, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wild Peloria, LLC was last updated on October 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.