Provider Demographics
NPI:1972229771
Name:PARRA SANTANA, RUTH (CADC-I, CGAC-R, CRM)
Entity type:Individual
Prefix:MS
First Name:RUTH
Middle Name:
Last Name:PARRA SANTANA
Suffix:
Gender:F
Credentials:CADC-I, CGAC-R, CRM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 SW CEDAR HILLS BLVD STE 170
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-2020
Mailing Address - Country:US
Mailing Address - Phone:503-626-1800
Mailing Address - Fax:
Practice Address - Street 1:3800 SW CEDAR HILLS BLVD STE 170
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2020
Practice Address - Country:US
Practice Address - Phone:503-626-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR23-CRM-1780175T00000X
ORTG-23-191101Y00000X
OR24-05-11104101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500812258Medicaid
OR23-CRM-1780OtherMHACBO (CRM)
OR24-05-11104OtherMHACBO (CADC)
ORTG-23-191OtherMHACBO (CGAC)