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General NPI Number Information
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NPI Number | 1407778103
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Entity Type | Organization
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Legal Business Name | COMMON KIN COLLABORATIVE, LLC
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 3050 SE DIVISION ST STE 220
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City | PORTLAND
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State | OR
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Zip | 97202-1997
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Country | US
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Telephone | 503-300-5332
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Fax | 503-328-7780
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Provider Business Mailing Address
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Address Line | 3050 SE DIVISION ST STE 220
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City | PORTLAND
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State | OR
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Zip | 97202-1997
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Country | US
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Telephone | 503-300-5332
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Fax | 503-328-7780
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Authorized Official
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Title or Position | MEMBER
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Name | ROXANNE SHEENA CAPPARELLI
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Credential | LCSW
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Telephone | 503-208-8258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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