Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ryan Austin Fullmer

Individual provider Mental Health Counselor · NPI 1750954442

Ryan Austin Fullmer is a Mental Health Counselor in Portland, Oregon. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

12505 SE Raymond St
Portland, OR 97236-3931
Phone: (503) 760-8300
Fax: (503) 760-8308
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1750954442
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 20, 2021
Last updated in NPPESJuly 20, 2021
Certification dateJuly 20, 2021

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