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Individual

DIANE K ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CADC III, QMHP

Contact information

Practice address
131 NE 102ND AVE, PORTLAND, OR 97220-4167
(503) 253-6754
(503) 253-8020
Mailing address
6440 CHESSINGTON LN, GLADSTONE, OR 97027-1011
(503) 353-6799

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YM0800X
Mental Health Counselor

Other

Enumeration date
10/04/2006
Last updated
08/21/2007
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