Provider Demographics
NPI:1538982103
Name:KEEVER, AUSTIN COLE (CADC-1)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:COLE
Last Name:KEEVER
Suffix:
Gender:M
Credentials:CADC-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20343 DANNY CT
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-8619
Mailing Address - Country:US
Mailing Address - Phone:503-449-3412
Mailing Address - Fax:
Practice Address - Street 1:20343 DANNY CT
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-8619
Practice Address - Country:US
Practice Address - Phone:503-449-3412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR23-03-10658101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)