Basic Information
| Provider Information | |||||||||
| NPI: | 1508195751 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUBER | ||||||||
| FirstName: | ERIKA | ||||||||
| MiddleName: | BETH | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | ERIKA RUBER | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | RUBER | ||||||||
| OtherFirstName: | ERIKA | ||||||||
| OtherMiddleName: | BETH | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | LCSW | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1020 NE TILLAMOOK ST | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972124060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036807292 | ||||||||
| FaxNumber: | 9712544882 | ||||||||
| Practice Location | |||||||||
| Address1: | 3500 NE MLK JR BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972122093 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036807292 | ||||||||
| FaxNumber: | 9712544882 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2009 | ||||||||
| LastUpdateDate: | 02/08/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | L3767 | OR | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.