Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 2034 | OR |
N | 175F00000X | Naturopath | NT0000967 | WA |
NPI | 1124152533 |
---|---|
Provider Name | Dr. Thomas Michael Rogers |
First Address | Corvallis, OR 97330 |
Second Address | Corvallis, OR 97330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 08/03/2016 |