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General NPI Number Information
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NPI Number | 1750645412
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Entity Type | Individual
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Provider Name | RUHAMA FREEMAN
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Gender | Female
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 2250 NW FLANDERS ST STE 201
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City | PORTLAND
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State | OR
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Zip | 97210-5410
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Country | US
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Telephone | 503-893-4858
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Fax |
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Provider Business Mailing Address
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Address Line | 1405 NE MCWILLIAMS RD STE 103
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City | BREMERTON
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State | WA
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Zip | 98311-3124
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Country | US
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Telephone | 503-893-4858
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LH61201069
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C4720
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License Number State | OR
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