Healthcare Provider Details

I. General information

NPI: 1083862775
Provider Name (Legal Business Name): ROSE SNYDER ED.M., PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2008
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 WILLAMETTE FALLS DR STE 220
WEST LINN OR
97068-4655
US

IV. Provider business mailing address

1880 WILLAMETTE FALLS DR STE 220
WEST LINN OR
97068-4655
US

V. Phone/Fax

Practice location:
  • Phone: 510-847-0987
  • Fax:
Mailing address:
  • Phone: 510-847-0987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY3436
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: