Healthcare Provider Details
I. General information
NPI: 1073480737
Provider Name (Legal Business Name): TRUBRIETY OREGON PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2025
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14473 SW 90TH AVE
TIGARD OR
97224-6039
US
IV. Provider business mailing address
14473 SW 90TH AVE
TIGARD OR
97224-6039
US
V. Phone/Fax
- Phone: 503-314-9067
- Fax:
- Phone: 503-314-9067
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
BRUCE
ZUFELT
Title or Position: PRESIDENT
Credential: LCSW
Phone: 503-314-9067