Keaton Randolph

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

T-25-5233 Issued in OR

Practice address

10600 SE McLoughlin Blvd Ste 207
Milwaukie, OR 97222-7428

Phone

(855) 770-0577

NPI assigned

Apr 28, 2026

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pacific Crest Trail Detox LLC

  • Substance Abuse Rehabilitation Facility
  • Milwaukie, OR
  • NPI 1043760838
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1777334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1245176403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10600 SE MCLOUGHLIN BLVD STE 207",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972227428",
            "telephone_number": "855-770-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10600 SE MCLOUGHLIN BLVD STE 207",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972227428",
            "telephone_number": "855-770-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "KEATON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-28",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-25-5233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Ramirez
• Mario Ramos
• Jasudha Ranabhat, NP
• Benjamin D Randolph, CADCIII
• Jennifer Randolph, CADC-II, CIP, CAI-II
• Renee' Lorena Raschke, BS, QMHA, CADC 1,
• Carol Rasmusen
• Jessica D Raymond, LMT
• Ivy Rayn
• Joshua D Reagan, MD

• Addiction (Substance Use Disorder) Counselor in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.