De La Rosa, Dorothy R

De La Rosa, Dorothy R is an individual health care provider with primary practice located at 9605 Grand Ronde Rd , Grand Ronde OR 97347-9712. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. De La Rosa, Dorothy R can be contacted via phone (503) 879-2060.

Contact Information

Primary practice address
9605 Grand Ronde Rd Grand Ronde OR 97347-9712
Phone: (503) 879-2060
Fax: (503) 879-2071
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 21-03-20041 Oregon

Profile Details

NPI number 1659863215
LBN Legal business name De La Rosa, Dorothy R
Credentials CDAC II
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2018
Last updated Aug 16th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659863215 NPPES
Oregon MEDICAID 500764712

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