Provider Demographics
NPI:1508195751
Name:RUBER, ERIKA BETH (ERIKA RUBER)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:BETH
Last Name:RUBER
Suffix:
Gender:F
Credentials:ERIKA RUBER
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:BETH
Other - Last Name:RUBER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1020 NE TILLAMOOK ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-4060
Mailing Address - Country:US
Mailing Address - Phone:503-680-7292
Mailing Address - Fax:971-254-4882
Practice Address - Street 1:3500 NE MLK JR BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-2093
Practice Address - Country:US
Practice Address - Phone:503-680-7292
Practice Address - Fax:971-254-4882
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-17
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL3767101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor