Individual provider Active NPI

Ruth Sue Gibian, L.C.S.W.

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1669531562
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L2259 Issued in OR
Practice address
2311 E Burnside St
Portland, OR 97214-1655
Phone
(503) 222-3125
NPI assigned
Dec 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L2259 OR Primary
Clinical Social Worker 1041C0700X LW00008380 WA

Addresses

Primary practice location

2311 E Burnside St
Portland, OR 97214-1655

Mailing address

2311 E Burnside St
Portland, OR 97214-1655
Phone (503) 222-3125

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150827000266 OR Practitioner - Clinical Social Worker 7416263090 Reassigns benefits to 1 organization
Practice locations: Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Portland, OR 97214
Phone (503) 222-3125

4110 SE Hawthorne Blvd
Suite 219
Portland, OR 97214-5246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L2259ORMDClinical Social Worker
LW00008380WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Salal Psychotherapy CurrentSince Jul 3, 2021 Accepting new patients

Locations

1732 SE Ash St
Portland, OR 97214
Phone (503) 235-6171

4110 SE Hawthorne Blvd
Portland, OR 97214
Phone (503) 383-9350

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669531562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141655",
            "telephone_number": "503-222-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141655",
            "telephone_number": "503-222-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBIAN",
        "first_name": "RUTH",
        "middle_name": "SUE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L2259",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00008380",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.