Provider Demographics
NPI:1437721768
Name:FRIEND, KAYCEE N (CRM)
Entity Type:Individual
Prefix:
First Name:KAYCEE
Middle Name:N
Last Name:FRIEND
Suffix:
Gender:F
Credentials:CRM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 882
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-0882
Mailing Address - Country:US
Mailing Address - Phone:541-429-8844
Mailing Address - Fax:541-429-8822
Practice Address - Street 1:200 SE HAILEY AVE STE 301
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-3072
Practice Address - Country:US
Practice Address - Phone:541-663-4232
Practice Address - Fax:541-429-8822
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
OR20CRM187175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)