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General NPI Number Information
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NPI Number | 1881819563
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Entity Type | Individual
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Provider Name | DARYL SPENCER RUTHVEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2575 CENTER ST NE COUNSELING & TREATMENT SERVICES
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City | SALEM
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State | OR
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Zip | 97310-0001
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Country | US
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Telephone | 503-378-8373
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Fax | 503-378-5118
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Provider Business Mailing Address
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Address Line | 6193 81ST AVE SE
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City | SALEM
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State | OR
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Zip | 97301-9109
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Country | US
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Telephone | 503-749-3486
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD15686
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License Number State | OR
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