Provider Demographics
NPI:1346035805
Name:ROSE, HILLARY LAUREN (CSWA)
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:LAUREN
Last Name:ROSE
Suffix:
Gender:
Credentials:CSWA
Other - Prefix:
Other - First Name:H. LAUREN
Other - Middle Name:ELIZABETH
Other - Last Name:ROSE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6301 NE WILLIAM R CARR ST
Mailing Address - Street 2:
Mailing Address - City:ADAIR VILLAGE
Mailing Address - State:OR
Mailing Address - Zip Code:97330-9656
Mailing Address - Country:US
Mailing Address - Phone:541-368-1868
Mailing Address - Fax:
Practice Address - Street 1:3509 NW SAMARITAN DR
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3893
Practice Address - Country:US
Practice Address - Phone:541-768-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA161521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical