| Cemented Rose Therapeutics, Llc | |
|
4110 Ne 122nd Ave Ste 115 Portland OR 97230-1384 | |
| (971) 227-3553 | |
| Not Available |
| Full Name | Cemented Rose Therapeutics, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4110 Ne 122nd Ave Ste 115, Portland, Oregon |
| Authorized Official Name and Position | Sharnissa T Secrett (BEHAVIORAL HEALTH DIRECTOR) |
| Authorized Official Contact | 9712273553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cemented Rose Therapeutics, Llc 4110 Ne 122nd Ave Ste 115 Portland OR 97230-1384 Ph: (971) 227-3553 | Cemented Rose Therapeutics, Llc 4110 Ne 122nd Ave Ste 115 Portland OR 97230-1384 Ph: (971) 227-3553 |
| NPI Number | 1699205773 |
|---|---|
| Provider Enumeration Date | 06/12/2017 |
| Last Update Date | 09/06/2023 |
| Certification Date | 09/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699205773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | L6941 (Oregon) | Primary |
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