MEDICARE: DR. RONALD CARY FOX PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC22194	CA
2	106H00000X	Marriage & Family Therapist	T1876	OR

General Provider Information

NPI Number	:	1538436795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD CARY FOX PH.D.

Provider Business Mailing Address
First Line	:	4110 SE HAWTHORNE BLVD # 112
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-5246
Country	:	US
Telephone Number	:	971-284-5617
Fax Number	:

Provider Business Practice Location Address
First Line	:	2705 E BURNSIDE ST STE 206
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-1768
Country	:	US
Telephone Number	:	971-284-5617
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2011
Last Update Date	:	01/05/2024

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