MEDICARE: MRS. LINDA CLIFFORD ROCKWELL MSW LCSW BCD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0158	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023089810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA CLIFFORD ROCKWELL MSW LCSW BCD

Provider Business Mailing Address
First Line	:	2188 SW PARK PL
Second Line	:	SUITE 301
City	:	PORTLAND
State	:	OR
Zip	:	97205-1100
Country	:	US
Telephone Number	:	503-241-3606
Fax Number	:	503-294-0899

Provider Business Practice Location Address
First Line	:	2188 SW PARK PL
Second Line	:	SUITE 301
City	:	PORTLAND
State	:	OR
Zip	:	97205-1100
Country	:	US
Telephone Number	:	503-241-3606
Fax Number	:	503-294-0899

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	07/08/2007

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