MEDICARE: ROSE MARY COLORAFI LPC, LMHC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1669845897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSE MARY COLORAFI LPC, LMHC, NCC

Provider Business Mailing Address
First Line	:	5517 SE 89TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97266-4734
Country	:	US
Telephone Number	:	503-427-9543
Fax Number	:

Provider Business Practice Location Address
First Line	:	4023 NE TILLAMOOK ST # 2
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97212-5341
Country	:	US
Telephone Number	:	503-427-9543
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2015
Last Update Date	:	03/08/2023

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