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General NPI Number Information
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NPI Number | 1437235900
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Entity Type | Individual
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Provider Name | CHRISTINA OPAL ROSE LPC
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Gender | Female
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 1832 NE BROADWAY ST
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City | PORTLAND
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State | OR
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Zip | 97232-1992
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Country | US
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Telephone | 503-282-8600
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Fax | 503-287-0967
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Provider Business Mailing Address
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Address Line | 1832 NE BROADWAY ST
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City | PORTLAND
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State | OR
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Zip | 97232-1992
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Country | US
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Telephone | 503-282-8600
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Fax | 503-287-0967
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C1448
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License Number State | OR
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