Individual
ALICE PENNIMAN ROSE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5125 SW MACADAM AVE, STE 145, PORTLAND, OR 97239
(503) 231-7854
(503) 231-8153
Mailing address
5125 SW MACADAM AVE, STE 145, PORTLAND, OR 97239
(503) 231-7854
(503) 231-8153
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW2352
OR
Other
Enumeration date
04/04/2006
Last updated
07/08/2007
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