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RYAN AUSTIN FULLMER
NPI 1750954442
Counselor - Mental Health in Portland, OR

Active since July 20, 2021
12505 SE RAYMOND ST, PORTLAND, OR 97236(503) 760-8300(503) 760-8308 Get Directions Write a Review

NPPES record last updated: July 20, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ryan Austin Fullmer NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RYAN AUSTIN FULLMER (NPI 1750954442) is an individual mental health provider in Portland, Oregon and active in the NPI registry since July 2021.

NPPES Registry Identity

NPI1750954442
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameRYAN AUSTIN FULLMER
Location Address12505 SE RAYMOND STPortland, OR 97236-3931
Mailing Address3587 Heathrow WayMedford, OR 97504-4004 · (541) 858-8170 · Fax (541) 858-8167
Phone(503) 760-8300
Fax(503) 760-8308
Sole ProprietorNo
Enumeration DateJuly 20, 2021
NPPES CertifiedJuly 20, 2021
✔ NPI 1750954442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
12505 SE RAYMOND ST, Portland, OR 97236
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHELLEY ARNESON
Counselor (Mental Health)
12505 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 760-8300
LISA BETH RYAN
Counselor (Mental Health)
12505 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 760-8300
NANCYANNE SMITH
Counselor (Mental Health)
12505 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 760-8300
JULIA A DEMARRE
Counselor (Mental Health)
12505 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 760-8300
COREY HALL
Counselor (Mental Health)
12505 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 760-8300
WILL KHOA ALEXANDER
Counselor (Mental Health)
12505 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 760-8300
JOHN RYAN
Counselor (Mental Health)
12505 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 760-8300
MARIE ANTOINETTE CARTER
Counselor (Mental Health)
12505 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 760-8300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ryan Fullmer's NPI number?

The NPI number for Ryan Fullmer is 1750954442. It was assigned to this individual provider in the NPPES registry on July 20, 2021.

Where is Ryan Fullmer located?

Ryan Fullmer practices at 12505 SE Raymond St, Portland, OR 97236. The listed phone number is (503) 760-8300.

What is Ryan Fullmer's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Ryan Fullmer was last updated on July 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.