Provider Demographics
NPI:1043544372
Name:ROMBERG, AMY (BA IN FRENCH, MSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ROMBERG
Suffix:
Gender:F
Credentials:BA IN FRENCH, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 SE WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-3160
Mailing Address - Country:US
Mailing Address - Phone:503-666-3808
Mailing Address - Fax:503-666-6835
Practice Address - Street 1:4101 NE DIVISION ST
Practice Address - Street 2:# 100
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-4617
Practice Address - Country:US
Practice Address - Phone:503-666-3808
Practice Address - Fax:503-666-6835
Is Sole Proprietor?:No
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist