Individual
KIMBERLY DAWN ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
58646 MCNULTY WAY, SAINT HELENS, OR 97051-6210
(971) 203-1316
(503) 397-5373
Mailing address
PO BOX 1234, SAINT HELENS, OR 97051-8234
(971) 203-1316
(503) 397-5373
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
20-CRM-161
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-CRM-161
CERTIFIED RECOVERY MENTOR
OR
Enumeration date
07/16/2020
Last updated
10/24/2022
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