Provider Demographics
NPI:1336839984
Name:PEMBERTON, ROWEN (LMSW)
Entity Type:Individual
Prefix:
First Name:ROWEN
Middle Name:
Last Name:PEMBERTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:RENEE
Other - Last Name:PEMBERTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:151 W 7TH AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2676
Mailing Address - Country:US
Mailing Address - Phone:541-239-7280
Mailing Address - Fax:
Practice Address - Street 1:151 W 7TH AVE STE 210
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2676
Practice Address - Country:US
Practice Address - Phone:541-239-7280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORM13765104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker