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General NPI Number Information
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NPI Number | 1740535863
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Entity Type | Individual
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Provider Name | STEFFANNIE ROACHE LPC
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Gender | Female
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Dates
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Enumeration Date | 07/14/2012
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 985 NE 24TH ST
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City | GRESHAM
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State | OR
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Zip | 97030-2905
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Country | US
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Telephone | 503-333-3306
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Fax | 866-959-3177
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Provider Business Mailing Address
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Address Line | 6507 68TH ST NE
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City | MARYSVILLE
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State | WA
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Zip | 98270-5346
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Country | US
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Telephone | 971-717-2307
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Fax | 866-959-3177
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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 | C3929
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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