Bret Eugene Fuller, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

1839 Issued in OR

Practice address

037 SW Hamilton St
Ste 3
Portland, OR 97239-4096

Phone

(503) 220-8262

Fax

(503) 220-3499

NPI assigned

Dec 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1477737294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "037 SW HAMILTON ST",
            "address_2": "STE 3",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394096",
            "telephone_number": "503-754-2634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "037 SW HAMILTON ST",
            "address_2": "STE 3",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394096",
            "telephone_number": "503-220-8262",
            "fax_number": "503-220-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "BRET",
        "middle_name": "EUGENE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-28",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OR",
            "license": "1839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah K Fulkerson, OT
• Full Circle Community Services
• Full Circle Ecotherapy and Family Services LLC
• Full Moon Wellness and Consulting, LLC
• Full Spectrum Therapy LLC
• Chelsey Marie Fuller
• Jesse Fuller
• Joleen Fuller, LAC
• Julia M Fuller, M.AC.O.M.
• Kenneth Daniel Fuller, LMT

• Counseling Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Counseling Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.