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Individual

DR. INGRID ROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D LPC

Contact information

Practice address
922 NW 11TH AVE, APT 403, PORTLAND, OR 97209-2776
(503) 248-1608
(503) 248-1608
Mailing address
922 NW 11TH AVE, APT 403, PORTLAND, OR 97209-2776
(503) 248-1608
(503) 248-1608

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
C3057
OR

Other

Enumeration date
11/06/2006
Last updated
05/29/2013
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