Individual
RUBEN REYES SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
3500 NE MLK BLVD, SUITE 200, PORTLAND, OR 97212-2093
(503) 327-8205
Mailing address
6221 NE GOING ST, PORTLAND, OR 97218-3133
(503) 757-5439
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TF0200X
Forensic Psychologist
—
—
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164936
—
OR
Enumeration date
09/07/2016
Last updated
09/07/2016
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