NPI 1104787704

Pacificsource Pace, LLC

Organisation PACE Provider Organization Springfield, OR

Practice location

Address: 555 International Way STE B104, Springfield, OR 97477-6013
Phone: (458) 544-0400

Authorised official

Name: Kristin Kernutt
Title: Chief Legal Counsel
Phone: (541) 225-1967

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X

Other Program of All-Inclusive Care for the Elderly (PACE) Provider Organization providers in Oregon →

Registry record

NPI: 1104787704
Entity type: Organization
NPI issued: 21 Nov 2025
Record last updated: 16 Jul 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.