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Individual

MR. DANIEL KEITH ROTHENBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5200 S MACADAM AVE, PORTLAND, OR 97239-6103
(503) 333-8988
Mailing address
5200 S MACADAM AVE, PORTLAND, OR 97239-6103
(503) 333-8988

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L7307
OR
1041C0700X
Clinical Social Worker
LCSW65037
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95-2633765
MEDI-CAL
CA
Enumeration date
08/03/2011
Last updated
02/19/2026
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