Desiree Forrest Rudder, LMT,CADC I

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

18-08-32 Issued in OR

Practice address

2111 Front St NE Ste 3-101
Salem, OR 97301-0038

Phone

(503) 508-7868

NPI assigned

Sep 7, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/bridgewayrecovery/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bridgeway Recovery Services

  • Addiction (Substance Use Disorder) Counselor
  • Salem, OR
  • NPI 1083844401
  NPD (past)

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1568779916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 SAGINAW ST S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024122",
            "telephone_number": "503-503-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 FRONT ST NE STE 3-101",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010038",
            "telephone_number": "503-508-7868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 E Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Stayton",
            "state": "OR",
            "postal_code": "973831855",
            "country_code": "US",
            "telephone_number": "503-363-2021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDDER",
        "first_name": "DESIREE",
        "middle_name": "FORREST",
        "name_prefix": "Ms.",
        "credential": "LMT,CADC I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "OR",
            "license": "14427",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "18-08-32",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodolfo Ruano Solorzano, DPT
• Molly Faye Rubens, ND
• Shayna Rene Rubi
• Kendrick Rubino, DO
• Heather Christine Ruddell
• Camie Ruden
• Thomas Rudisill
• Christine J Rue, PA-C
• Eric Ruef
• Karen Janet Ruelas

• Addiction (Substance Use Disorder) Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.