Healthcare Provider Details

I. General information

NPI: 1457272072
Provider Name (Legal Business Name): AMY KITTRIDGE ROTHKOPF RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3116 SE 193RD AVE
CAMAS WA
98607-9453
US

IV. Provider business mailing address

3116 SE 193RD AVE
CAMAS WA
98607-9453
US

V. Phone/Fax

Practice location:
  • Phone: 503-757-3201
  • Fax:
Mailing address:
  • Phone: 503-757-3201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: