Individual provider · Type 1 NPI

Randolph Lucero, CRM, PSS-AD

Peer Specialist · Gresham, OR

NPI number 1629984133 Active

Practice location

355 NW Division St
Gresham, OR 97030-5523

Call (503) 545-9754 Map

Mailing address

211 SE Caruthers St
Portland, OR 97214-4502

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist 175T00000X115678 (OR)
Peer Specialist Primary 175T00000X25-CRM-5021 (OR)

Peer Specialist: 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.

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About NPI 1629984133

Randolph Lucero, CRM, PSS-AD's National Provider Identifier is 1629984133, issued on Aug 24, 2026. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Gresham, OR. The record was last updated on Aug 24, 2026.