Robert Puckett, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

70245 Issued in CA

Practice address

2302 SE Salmon St
Portland, OR 97214-3944

Phone

(323) 217-3460

NPI assigned

Sep 1, 2016

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560038400000",
    "number": "1891242236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 SE 23RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143905",
            "telephone_number": "323-217-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 SE SALMON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143944",
            "telephone_number": "323-217-3460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "626 Balboa St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941183725",
            "country_code": "US",
            "telephone_number": "323-217-3460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "ROBERT",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2019-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "70245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "PORTLAND",
            "affiliation": "N",
            "address_1": "2302 SE Salmon St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972143944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Marie Ptaszynski
• Ptmobile Physical Therapy LLC
• Patrick C. Pua, P.T.
• Sherly Pual
• Jerrod Puckett, DC
• Gopal Pudasaini, MEDICAL STUDENT
• Ritika Pudota, DO
• Katherine H Pugh, N.D.
• Tia Pugh
• Mark E Puhlman, ANP

• Marriage & Family Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.