# CEMENTED ROSE THERAPEUTICS, LLC

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

## Provider details

- **NPI number:** 1699205773
- **Authorized official:** SHARNISSA T SECRETT (BEHAVIORAL HEALTH DIRECTOR)
- **Authorized official phone:** (971) 227-3553

## Contact information

- **Practice address:** 4110 NE 122ND AVE STE 115, PORTLAND, OR 97230-1384
- **Practice address phone:** (971) 227-3553
- **Mailing address:** 4110 NE 122ND AVE STE 115, PORTLAND, OR 97230-1384
- **Mailing address phone:** (971) 227-3553

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | L6941 | OR | Yes |

## Other

- **Enumeration date:** 06/12/2017
- **Last updated:** 09/06/2023