# BOB ROSS, LCSW, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356857999
- **Authorized official:** ROBERT C ROSS LCSW (MEMBER/MANAGER)
- **Authorized official phone:** (503) 453-3968

## Contact information

- **Practice address:** 12250 SW 2ND ST, BEAVERTON, OR 97005-2828
- **Practice address phone:** (971) 249-2319
- **Mailing address:** 13190 SW TRIGGER DR, BEAVERTON, OR 97008-7689
- **Mailing address phone:** (503) 453-3968

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 12/19/2017
- **Last updated:** 12/19/2017