Individual
AUTUMN RODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11740 SW 68TH PKWY STE 200, TIGARD, OR 97223-9058
(425) 477-4216
Mailing address
165 DARLINGTON ST, MEDFORD, OR 97501-2892
(860) 989-2552
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C10125
OR
101YM0800X
Mental Health Counselor
—
OR
106S00000X
Behavior Technician
—
OR
Other
Enumeration date
01/17/2020
Last updated
08/08/2025
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