Active NPI
Diana M. Debruin
- Professional Counselor
- Portland, OR
National Provider Identifier
1386066397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C0983
- Practice address
- 7412 SW Beaverton Hillsdale Hwy Ste 204
Portland, OR 97225-2168 - Phone
- (503) 719-2799
- Fax
- (888) 972-3736
- NPI assigned
- Jan 9, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 501728 | OR | |
| Professional Counselor | 101YP2500X | C0983 | OR | Primary |
Addresses
Primary practice location
7412 SW Beaverton Hillsdale Hwy Ste 204
Portland, OR 97225-2168
Mailing address
7412 SW Beaverton Hillsdale Hwy Ste 204
Portland, OR 97225-2168
Phone (503) 719-2799
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
| License | State | Type | Specialty |
|---|---|---|---|
| 501728 | OR | MD | Addiction (Substance Use Disorder) Counselor |
| C0983 | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389225600000",
"number": "1386066397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7412 SW BEAVERTON HILLSDALE HWY STE 204",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972252168",
"telephone_number": "503-719-2799",
"fax_number": "888-972-3736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7412 SW BEAVERTON HILLSDALE HWY STE 204",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972252168",
"telephone_number": "503-719-2799",
"fax_number": "888-972-3736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBRUIN",
"first_name": "DIANA",
"middle_name": "M.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-09",
"last_updated": "2014-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "501728",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C0983",
"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 Jan 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.