NEW LIFE WELLNESS LLC
NPI 1508463639
Preventive Medicine - Addiction Medicine in Hermiston, OR
NPI Status: Active since October 01, 2020
Contact Information
256 E HURLBURT AVE STE 117
HERMISTON, OR
ZIP 97838
Phone: (541) 303-3558
Fax: (509) 593-4644
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.
- Organization
- Preventive Medicine
- Addiction Medicine
- Accepts Insurance
- CLIA Number: 38D2309350
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-12-2026
About NEW LIFE WELLNESS LLC
This page provides the complete NPI Profile along with additional information for New Life Wellness Llc, a provider established in Hermiston, Oregon operating as a Preventive Medicine, focusing in addiction medicine . The healthcare provider is registered in the NPI registry with number 1508463639 assigned on October 2020. The practitioner's primary taxonomy code is 2083A0300X. The provider is registered as an organization and their NPI record was last updated June 2026. New Life Wellness Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Randall Kelly Dmsc Pac Mhs (Physician Assistant, Owner)
- NPI
- 1508463639
- Provider Name
- NEW LIFE WELLNESS LLC
- Entity Type
- Organization
- Location Address
- 256 E HURLBURT AVE STE 117 HERMISTON, OR 97838
- Location Phone
- (541) 303-3558
- Location Fax
- (509) 593-4644
- Mailing Address
- 5426 ROAD 68 STE D253 PASCO, WA 99301
- Mailing Phone
- (541) 303-3558
- Mailing Fax
- (509) 593-4644
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-01-2020
- Last Update Date
- 06-10-2026
- Code Navigator
Location Map
Secondary Locations
- 520 NW 4th St
Corvallis, OR 97330
(541) 303-3558 - 71 Centennial Loop Ste A
Eugene, OR 97401
(541) 303-3558 - 124 W Kennewick Ave Ste 11
Kennewick, WA 99336
(541) 303-3558 - 2900 NW Clearwater Dr
Bend, OR 97703
(541) 303-3558 - 4909 S Coast Hwy Ste 1K
South Beach, OR 97366
(541) 303-3558 - 278 E High St Ste 209
Stayton, OR 97383
(541) 303-3558 - 1901 Garden Ave Ste 210
Eugene, OR 97403
(541) 303-3558 - 1110 SE Alder St Ste 301
Portland, OR 97214
(541) 303-3558 - 1345 NW 15th St
Lincoln City, OR 97367
(541) 303-3558 - 761 Main St
Dallas, OR 97338
(541) 303-3558
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Preventive Medicine Addiction Medicine
- Taxonomy Code
- 2083A0300X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | |
| 2 | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | |
| 3 | 261QM2500X | Ambulatory Health Care Facilities | Clinic/Center | |
| 4 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | |
| 5 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BridgeSpan Standard Bronze Plan - EPO
- BridgeSpan Standard Gold Plan - EPO
- BridgeSpan Standard Silver Plan - EPO
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
- Premera Blue Cross Family Dental - PPO
- Premera Blue Cross Pediatric Dental - PPO
- Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
- Bronze HSA 7000 Individual Connect - EPO
- Gold 2300 Individual Connect - EPO
- Regence Standard Bronze Plan Individual Connect - EPO
- Regence Standard Gold Plan Individual Connect - EPO
- Regence Standard Silver Plan Individual Connect - EPO
- Silver 6500 Individual Connect - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 500698482 | MEDICAID (05) | OR |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 38D2309350
- Facility Type
- Physician Office
- Certificate Effective Date
- December 13, 2024
- Certificate Expiration Date
- December 12, 2026
- Laboratory Director
- RANDALL KELLY
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to New Life Wellness Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
Reviews for NEW LIFE WELLNESS LLC
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1508463639, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 71 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
HERMISTON, OR 97838
HERMISTON, OR 97838
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1508463639, enumerated as an "organization" on October 01, 2020.
The provider is located at 256 E HURLBURT AVE STE 117 HERMISTON, OR 97838 and the phone number is (541) 303-3558.
Preventive Medicine with taxonomy code 2083A0300X and a focus in Addiction Medicine.
The provider might be accepting Accepts: BridgeSpan Health Company, Moda Health Plan, Inc.,. Please consult your insurance carrier or call the provider to verify.
