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Individual

MR. DOUGLASS MCDONALD RUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S.W., L.C.S.W.

Contact information

Practice address
1221 SW YAMHILL ST, SUITE 301, PORTLAND, OR 97205-2126
(503) 226-7079
(503) 226-1130
Mailing address
4213 NE 28TH AVE, PORTLAND, OR 97211-7103
(503) 705-3134
(440) 756-1547

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1041C0700X
Clinical Social Worker
Primary
L004513
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
L004513
L.C.S.W
OR
Enumeration date
04/03/2007
Last updated
05/18/2021
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