=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336821412
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROYAL JOEY KRAHMER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2023
-----------------------------------------------------
Last Update Date | 01/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 905 MAIN ST STE 409
-----------------------------------------------------
City | KLAMATH FALLS
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97601-6064
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-887-2344
-----------------------------------------------------
Fax | 541-887-2291
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6200 SE KING RD.
-----------------------------------------------------
City | PORTAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-546-6377
-----------------------------------------------------
Fax | 503-546-9397
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | T-23-3136
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 25-QMHA-I-004887
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 175T00000X
-----------------------------------------------------
Taxonomy Name | Peer Specialist
-----------------------------------------------------
License Number | THW000108745
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 175T00000X
-----------------------------------------------------
Taxonomy Name | Peer Specialist
-----------------------------------------------------
License Number | 25-CRM-II-0358
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 175T00000X
-----------------------------------------------------
Taxonomy Name | Peer Specialist
-----------------------------------------------------
License Number | 108745
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------