Provider Demographics
NPI:1255832101
Name:SANCHEZ-ROSA, RODNEY (DC)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:
Last Name:SANCHEZ-ROSA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3933 NE MARTIN LUTHER KING JR BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-1154
Mailing Address - Country:US
Mailing Address - Phone:503-481-3369
Mailing Address - Fax:
Practice Address - Street 1:3933 NE MARTIN LUTHER KING JR BLVD STE 101
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-1154
Practice Address - Country:US
Practice Address - Phone:503-481-3369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-26
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5869111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty