Healthcare Provider Details

I. General information

NPI: 1255254926
Provider Name (Legal Business Name): HANNAH RUISI ND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705 E BURNSIDE ST STE 206 #43
PORTLAND OR
97214-1768
US

IV. Provider business mailing address

2705 E BURNSIDE ST STE 206 #43
PORTLAND OR
97214-1768
US

V. Phone/Fax

Practice location:
  • Phone: 512-777-8432
  • Fax:
Mailing address:
  • Phone: 512-777-8432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: DR. HANNAH HUNTLY RUISI
Title or Position: PRIMARY CARE PHYSICIAN
Credential: ND
Phone: 971-239-1435