Dorothy R De la Rosa, CDAC II

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

21-03-20041 Issued in OR

Practice address

9605 Grand Ronde Rd
Grand Ronde, OR 97347-9712

Phone

(503) 879-2060

Fax

(503) 879-2071

NPI assigned

May 30, 2018

Last updated

Aug 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: dorothy.delarosa.p1@direct.grandronde.nextgenshare.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1659863215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9605 GRAND RONDE RD",
            "city": "GRAND RONDE",
            "state": "OR",
            "postal_code": "973479712",
            "telephone_number": "503-879-2060",
            "fax_number": "035-879-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9605 GRAND RONDE RD",
            "city": "GRAND RONDE",
            "state": "OR",
            "postal_code": "973479712",
            "telephone_number": "503-879-2060",
            "fax_number": "503-879-2071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 SE Washington St",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971234230",
            "country_code": "US",
            "telephone_number": "503-648-0753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA ROSA",
        "first_name": "DOROTHY",
        "middle_name": "R",
        "credential": "CDAC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-30",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "21-03-20041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500764712",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Confederated Tribes of Grand Ronde Community of Oregon Dba GR Health &
• Confederated Tribes of the Grand Ronde Community of Oregon
• Confederated Tribes of the Grand Ronde Community of Oregon
• Confederated Tribes of the Grand Ronde Community of Oregon (Confederated Tribes of Grand Ronde Health & Wellness Center Pharmacy)
• Joseph Shane Cox
• Cyaandi Rhone Dove, D.P.M.
• Casey Eash, LPC, CADC I
• Nicole Marie Estrada, LMFT, LPC
• Carolyn S Fairfax, MD
• Troyce Fortune

• Addiction (Substance Use Disorder) Counselor in Grand Ronde, OR
• Providers in Grand Ronde, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.