Active NPI
Ruben Reyes Santiago, MSW
- Social Worker
- Portland, OR
National Provider Identifier
1740737766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 3500 NE MLK Blvd
Suite 200
Portland, OR 97212-2093 - Phone
- (503) 327-8205
- NPI assigned
- Sep 7, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | |||
| Cognitive & Behavioral Psychologist | 103TB0200X | |||
| Forensic Psychologist | 103TF0200X | |||
| Social Worker | 104100000X | Primary | ||
| Clinical Social Worker | 1041C0700X | |||
| Marriage & Family Therapist | 106H00000X |
Addresses
Primary practice location
3500 NE MLK Blvd
Suite 200
Portland, OR 97212-2093
Mailing address
6221 NE Going St
Portland, OR 97218-3133
Phone (503) 757-5439
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164936 | Medicaid | OR |
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": "1473206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473206400000",
"number": "1740737766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6221 NE GOING ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972183133",
"telephone_number": "503-757-5439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 NE MLK BLVD",
"address_2": "SUITE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972122093",
"telephone_number": "503-327-8205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES SANTIAGO",
"first_name": "RUBEN",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-07",
"last_updated": "2016-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "164936",
"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 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.