Provider Demographics
NPI:1063241222
Name:ROSSER, FORREST WILLIAM (LMFT)
Entity type:Individual
Prefix:MR
First Name:FORREST
Middle Name:WILLIAM
Last Name:ROSSER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 SW GRIFFITH DR STE 235
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-4649
Mailing Address - Country:US
Mailing Address - Phone:971-217-6475
Mailing Address - Fax:503-526-3912
Practice Address - Street 1:4900 SW GRIFFITH DR STE 235
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-4649
Practice Address - Country:US
Practice Address - Phone:971-217-6475
Practice Address - Fax:503-526-3912
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-27
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORTO336106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist