Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD60278948 | WA |
N | 208600000X | Surgeon | MD60278948 | WA |
Y | 2086S0102X | Surgical Critical Care | MD60278948 | WA |
NPI | 1336363290 |
---|---|
Provider Name | Dr. Benjamin Jason Rogoway |
First Address | Vancouver, WA 98664-1989 |
Second Address | Vancouver, WA 98664-1989 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 09/04/2013 |