Provider Demographics
NPI:1407499528
Name:ROOKARD, GABRIELLE ELISE (CSWA)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ELISE
Last Name:ROOKARD
Suffix:
Gender:F
Credentials:CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4790 SW WATSON AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-0511
Mailing Address - Country:US
Mailing Address - Phone:503-822-7970
Mailing Address - Fax:
Practice Address - Street 1:4790 SW WATSON AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-0511
Practice Address - Country:US
Practice Address - Phone:503-822-7970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA139081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical