Healthcare Provider Details

I. General information

NPI: 1497051916
Provider Name (Legal Business Name): TANUJINI ROSALIND CARLSON MA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TANUJINI ROSALIND SENTHIRAJAH MA MFT

II. Dates (important events)

Enumeration Date: 01/31/2011
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6030 SE 52ND AVE STE 204
PORTLAND OR
97206-6887
US

IV. Provider business mailing address

9390 SW IBACH CT
TUALATIN OR
97062-7073
US

V. Phone/Fax

Practice location:
  • Phone: 971-402-9488
  • Fax:
Mailing address:
  • Phone: 712-350-9149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: