=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265820187
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KRISTI L DAHLMAN, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/30/2014
-----------------------------------------------------
Last Update Date | 05/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 768 SW CHURCH ST UNIT 671
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97338-0826
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-417-0987
-----------------------------------------------------
Fax | 425-420-2668
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12715 SW HAVENCREST ST
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97225-4741
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-417-0987
-----------------------------------------------------
Fax | 425-420-2668
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PROVIDER
-----------------------------------------------------
Name | KRISTI LEE DAHLMAN
-----------------------------------------------------
Credential | MS, LPC, LMHC
-----------------------------------------------------
Telephone | 425-417-0987
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------