Provider Demographics
NPI:1932178266
Name:RUFF, RON H (MD)
Entity Type:Individual
Prefix:MR
First Name:RON
Middle Name:H
Last Name:RUFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 SW WESTGATE DR
Mailing Address - Street 2:241
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97221-2432
Mailing Address - Country:US
Mailing Address - Phone:503-297-7223
Mailing Address - Fax:503-297-7603
Practice Address - Street 1:7300 SW CHILDS RD
Practice Address - Street 2:SUITE A
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-7772
Practice Address - Country:US
Practice Address - Phone:503-612-8452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD17527207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR831224000OtherREGENCE BCBSO
OR035001Medicaid
OR831224000OtherREGENCE BCBSO
A93009Medicare UPIN
OR035001Medicaid