Individual provider Active NPI

Brennan Ralston

  • Mental Health Counselor
  • Tigard, OR
National Provider Identifier
1710352141
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
8915 SW Center St
Tigard, OR 97223-6307
Phone
(503) 726-3690
NPI assigned
Dec 10, 2015
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

8915 SW Center St
Tigard, OR 97223-6307

Mailing address

8915 SW Center St
Tigard, OR 97223-6307
Phone (503) 265-9756

Other practice location 1

14626 SE Powell Blvd Apt 106
Portland, OR 97236-2572
Phone (971) 254-9600

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

NPI Registry JSON

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1710352141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8915 SW CENTER ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236307",
            "telephone_number": "503-265-9756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8915 SW CENTER ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236307",
            "telephone_number": "503-726-3690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14626 SE Powell Blvd Apt 106",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972362572",
            "country_code": "US",
            "telephone_number": "971-254-9600",
            "fax_number": "971-254-9598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RALSTON",
        "first_name": "BRENNAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.