Individual provider Active NPI

Angeline Rebecca Treffry Dickerson

  • Addiction (Substance Use Disorder) Registered Nurse
  • Klamath Falls, OR
National Provider Identifier
1811853518
Registry record updated Dec 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
201390813 Issued in OR
Practice address
2555 Main St
Klamath Falls, OR 97601-2723
Phone
(541) 883-2795
NPI assigned
Dec 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 201390813 OR Primary

Addresses

Primary practice location

2555 Main St
Klamath Falls, OR 97601-2723

Mailing address

24140 Bliss Rd
Sprague River, OR 97639-8644
Phone (503) 507-4277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
201390813ORMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1766793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766793600000",
    "number": "1811853518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24140 BLISS RD",
            "city": "SPRAGUE RIVER",
            "state": "OR",
            "postal_code": "976398644",
            "telephone_number": "503-507-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 MAIN ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976012723",
            "telephone_number": "541-883-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREFFRY DICKERSON",
        "first_name": "ANGELINE",
        "middle_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-27",
        "last_updated": "2025-12-27",
        "certification_date": "2025-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "201390813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2025; 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.