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Organization

BOB ROSS, LCSW, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT C ROSS LCSW (MEMBER/MANAGER)
(503) 453-3968
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
12/19/2017
Last updated
12/19/2017
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