NEW LIFE WELLNESS LLC – Addiction Medicine (Preventive Medicine) Physician, NPI 1508463639
Addiction Medicine (Preventive Medicine) Physician
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for NEW LIFE WELLNESS LLC
4909 S Coast Hwy Ste 1K
South Beach, OR 973669667
Phone: (541) 303-3558
Fax: (509) 593-4644
Type: Location
124 W Kennewick Ave Ste 11
Kennewick, WA 993363830
Phone: (541) 303-3558
Fax: (509) 593-4644
Type: Location
520 NW 4th St
Corvallis, OR 973306411
Phone: (541) 303-3558
Fax: (509) 593-4644
Type: Location
1901 Garden Ave Ste 210
Eugene, OR 974034301
Phone: (541) 303-3558
Fax: (509) 593-4644
Type: Location
761 Main St
Dallas, OR 973383108
Phone: (541) 303-3558
Fax: (509) 593-4644
Type: Location
278 E High St Ste 209
Stayton, OR 973831788
Phone: (541) 303-3558
Fax: (509) 593-4644
Type: Location
1345 NW 15th St
Lincoln City, OR 973673327
Phone: (541) 303-3558
Fax: (509) 593-4644
Type: Location
71 Centennial Loop Ste A
Eugene, OR 974012443
Phone: (541) 303-3558
Fax: (509) 593-4644
Type: Location
3760 MARKET ST NE # 126
SALEM, OR 973011826
Phone: (206) 418-8222
Type: Mailing
4909 S COAST HWY STE K
SOUTH BEACH, OR 973669648
Phone: (206) 418-8222
Type: Location
1110 SE Alder St Ste 301
Portland, OR 972142400
Phone: (541) 303-3558
Fax: (509) 593-4644
Type: Location
2900 NW Clearwater Dr
Bend, OR 977039410
Phone: (541) 303-3558
Fax: (509) 593-4644
Type: Location
5601 CONCORD DR
PASCO, WA 993015462
Phone: (206) 418-8222
Fax: (509) 593-4644
Type: Location
5426 ROAD 68 STE D253
PASCO, WA 993015268
Phone: (541) 303-3558
Fax: (509) 593-4644
Type: Mailing
256 E HURLBURT AVE STE 117
HERMISTON, OR 978382443
Phone: (541) 303-3558
Fax: (509) 593-4644
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-02-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20230127001731 | O | Clinic/Group Practice | OR | TBD |
| O20230207000230 | O | Clinic/Group Practice | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97366)
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