Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1615 | OR |
NPI | 1134395221 |
---|---|
Provider Name | Dr. Gwendolyn Anne Rogers |
First Address | Lake Oswego, OR 97035-3401 |
Second Address | Tigard, OR 97223-2552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2008 |
Last Update Date | 15/06/2021 |