MR. TIMOTHY GABRIEL GRAHAM PSS CRM NPI 1457160368

NPI Information

NPI: 1457160368
Provider Name: MR. TIMOTHY GABRIEL GRAHAM, PSS, CRM
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address: 14024 SE HAROLD ST
PORTLAND, OR
ZIP 97236
Phone: (760) 529-2076

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NPI Details

MR. Timothy Gabriel Graham, PSS, CRM is a peer specialist in Portland, OR. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. MR. Timothy Gabriel Graham, PSS, CRM NPI is 1457160368. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

14024 SE HAROLD ST
PORTLAND, OR
ZIP 97236-201
Phone: (760) 529-2076

The enumeration date for this NPI number is 1/6/2025 and was last updated on 1/6/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	175T00000X	Peer Specialist		24-CRM-4000	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	24-CRM-4000	OTHER	OREGON	PSS CERTIFICATION (MHACBO)

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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