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Search › Oregon › 1041C0700X

Derrick Long

NPI 1740103548 · on the registry since 2026

Practice

Address
4110 Ne 122nd Ave
Portland, OR 97230
Phone
(971) 227-3553
Organisation at this address
Cemented Rose Therapeutics, Llc
Waller Wholistic Wellness & Consulting
Inferred from a shared address, not stated in the registry.
Clinicians at this address
11

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Licence states on file
OR
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-07-30

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon