Individual
TARA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4116 SE 67TH AVE, PORTLAND, OR 97206-3518
(503) 901-3180
Mailing address
4116 SE 67TH AVE, PORTLAND, OR 97206-3518
(503) 901-3180
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW61177852
WA
104100000X
Social Worker
—
—
Other
Enumeration date
12/31/2015
Last updated
02/17/2026
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