Provider Demographics
NPI:1194111344
Name:DAHMEN, KACEY DANYELLE
Entity type:Individual
Prefix:MS
First Name:KACEY
Middle Name:DANYELLE
Last Name:DAHMEN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KACEY
Other - Middle Name:DANYELLE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:995 BELLEVUE AVENUE
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:OR
Mailing Address - Zip Code:97027
Mailing Address - Country:US
Mailing Address - Phone:503-522-6800
Mailing Address - Fax:
Practice Address - Street 1:890 SE 82ND DRIVE
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:OR
Practice Address - Zip Code:97027
Practice Address - Country:US
Practice Address - Phone:503-659-5515
Practice Address - Fax:503-233-2693
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst