Active NPI
Shelley Ratterman, LCSW
- Clinical Social Worker
- Portland, OR
National Provider Identifier
1902018336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3122
- Practice address
- 1215 SW 18TH Ave
Portland, OR 97205-1711 - Phone
- (503) 756-2586
- NPI assigned
- May 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 3122 | OR | Primary |
Addresses
Primary practice location
1215 SW 18TH Ave
Portland, OR 97205-1711
Mailing address
1215 SW 18TH Ave
Portland, OR 97205-1711
Phone (503) 756-2586
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 291127 | Other | OR | MANAGED HLTH NETWORK |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3122 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902018336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 SW 18TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051711",
"telephone_number": "503-756-2586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 SW 18TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051711",
"telephone_number": "503-756-2586"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RATTERMAN",
"first_name": "SHELLEY",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "3122",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HLTH NETWORK",
"identifier": "291127",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.