Active NPI
Glenn Ruminson, MD
- Psychiatry Physician
- Portland, OR
National Provider Identifier
1356433619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 9408
- Practice address
- 10123 SE Market St
Portland, OR 97216-2532 - Phone
- (360) 263-5420
- Fax
- (360) 263-5406
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 9408 | OR | Primary |
Addresses
Primary practice location
10123 SE Market St
Portland, OR 97216-2532
Mailing address
PO Box 87670
Vancouver, WA 98687-7670
Phone (360) 263-5420
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9408 | OR | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224720000000",
"number": "1356433619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 87670",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986877670",
"telephone_number": "360-263-5420",
"fax_number": "360-263-5406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10123 SE MARKET ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972162532",
"telephone_number": "360-263-5420",
"fax_number": "360-263-5406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUMINSON",
"first_name": "GLENN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2008-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "9408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.