Provider Demographics
NPI:1770254104
Name:KEEN, RICHARD ARLEN (CADC-R, PSS)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ARLEN
Last Name:KEEN
Suffix:
Gender:M
Credentials:CADC-R, PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-1838
Mailing Address - Country:US
Mailing Address - Phone:541-699-6998
Mailing Address - Fax:541-527-4458
Practice Address - Street 1:150 SW 4TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1838
Practice Address - Country:US
Practice Address - Phone:541-699-6998
Practice Address - Fax:541-527-4458
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT-21-991101YA0400X
OR21-CRM-603175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)