Individual
AMANDA ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-5377
Mailing address
1261 NW OVERTON ST # 143, PORTLAND, OR 97209-3788
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L11610
OR
Other
Enumeration date
01/20/2021
Last updated
01/15/2024
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