Provider Demographics
NPI:1891817680
Name:WELLINGTON, DENA RUBY (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:DENA
Middle Name:RUBY
Last Name:WELLINGTON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14630 NW PERIMETER DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-5422
Mailing Address - Country:US
Mailing Address - Phone:503-936-8646
Mailing Address - Fax:
Practice Address - Street 1:11740 SW 68TH PKWY STE 200
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-9058
Practice Address - Country:US
Practice Address - Phone:503-205-4357
Practice Address - Fax:503-230-1371
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL105631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical