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:
Health care specialties
| Specialty | Code | License # | 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 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659863215 | NPPES |
| Oregon | MEDICAID | 500764712 |
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