Organization Active NPI

Ronald L Spangler, MD, PC

  • Psychiatry Physician
  • Portland, OR
National Provider Identifier
1417035767
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD16696 Issued in OR
Legal business name
RONALD L SPANGLER, MD, PC
Practice address
4805 NE Glisan St
3E
Portland, OR 97213-2933
Phone
(503) 624-2600
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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

Authorized official

Name
Dr. Ronald L Spangler, MD
Title
Owner
Phone
(503) 624-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X MD16696 OR Primary

Addresses

Primary practice location

4805 NE Glisan St
3E
Portland, OR 97213-2933

Mailing address

3439 NE Sandy Blvd
PMB 375
Portland, OR 97232-1959
Phone (503) 284-8841

Other identifiers 2

IdentifierTypeStateIssuer
1110691MedicaidWA
011408MedicaidOR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221782400000",
    "number": "1417035767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3439 NE SANDY BLVD",
            "address_2": "PMB 375",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321959",
            "telephone_number": "503-284-8841",
            "fax_number": "503-282-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST",
            "address_2": "3E",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-624-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD L SPANGLER, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2008-09-19",
        "status": "A",
        "authorized_official_last_name": "SPANGLER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-624-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD16696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1110691",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011408",
            "state": "OR"
        }
    ],
    "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 Sep 19, 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.

Verify at the official NPI Registry.