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KIMBERLY JAYE RANDALL CADC, CRM
NPI 1669991212
Peer Specialist in Portland, OR

Active since September 14, 2017
1030 NE COUCH ST, PORTLAND, OR 97232(503) 239-8400(503) 239-8406 Get Directions Write a Review

NPPES record last updated: August 31, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 31, 2023, Sep 14, 2017 (2 updates tracked since 2017).

About Kimberly Jaye Randall Cadc, Crm NPPES

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

KIMBERLY JAYE RANDALL CADC, CRM (NPI 1669991212) is an individual peer specialist in Portland, Oregon, licensed in Oregon (THW1868) and active in the NPI registry since September 2017. She maintains a secondary practice location in Portland.

NPPES Registry Identity

NPI1669991212
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameKIMBERLY JAYE RANDALLCredential: CADC, CRM
Location Address1030 NE COUCH STPortland, OR 97232
Mailing Address14600 Nw Cornell RdPortland, OR 97229-5442 · (503) 645-3581 · Fax (503) 629-8517
Phone(503) 239-8400
Fax(503) 239-8406
Sole ProprietorYes
Enumeration DateSeptember 14, 2017
Last NPPES UpdateAugust 31, 20232 updates tracked since enumeration
NPPES CertifiedAugust 31, 2023
✔ NPI 1669991212 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in OR · THW1868
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
1030 NE COUCH ST, Portland, OR 97232
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Secondary Practice Location 1

Location 11027 E. Burnside St.Portland, OR 97214 · Phone (503) 239-8400 · Fax (503) 239-8407

Other Identifiers 1

MedicaidTHW1868OR

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIKA CHRISTINE OLDENBROOK
Peer Specialist
1030 NE COUCH ST
PORTLAND, OR 97232
Multnomah County (503) 239-8400
AMBER CLARISSA RUBALCAVA
Counselor (Addiction (Substance Use Disorder))
1030 NE COUCH ST
PORTLAND, OR 97232
Multnomah County (503) 239-8400
KATHERINE ROCKER
Counselor (Addiction (Substance Use Disorder))
1030 NE COUCH ST
PORTLAND, OR 97232
Multnomah County (503) 239-8400
JAIME ABEL
Counselor (Mental Health)
1030 NE COUCH ST
PORTLAND, OR 97232
Multnomah County (503) 239-8400
MR. JEFFREY BRIAN KERR M.S., CADC I
Counselor (Addiction (Substance Use Disorder))
1030 NE COUCH ST
PORTLAND, OR 97232
Multnomah County (503) 239-8400
ELIZABETH BOND FNP
Nurse Practitioner (Family)
1030 NE COUCH ST
PORTLAND, OR 97232
Multnomah County (503) 239-8400
CARLO R OLKERIIL CADC I
Counselor (Addiction (Substance Use Disorder))
1030 NE COUCH ST
PORTLAND, OR 97232
Multnomah County (503) 239-8400
LAURA BEATRIZ LOPEZ-AYBAR
Counselor (Addiction (Substance Use Disorder))
1030 NE COUCH ST
PORTLAND, OR 97232
Multnomah County (503) 239-8400

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 Kimberly Randall's NPI number?

The NPI number for Kimberly Randall is 1669991212. It was assigned to this individual provider in the NPPES registry on September 14, 2017.

Where is Kimberly Randall located?

Kimberly Randall practices at 1030 NE Couch St, Portland, OR 97232. The listed phone number is (503) 239-8400.

What is Kimberly Randall's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Kimberly Randall was last updated on August 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.