Provider Demographics
NPI:1609900018
Name:ROGERS, ALICIA DAWN (ND)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:DAWN
Last Name:ROGERS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 NW 4TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-6491
Mailing Address - Country:US
Mailing Address - Phone:541-602-0260
Mailing Address - Fax:541-243-4217
Practice Address - Street 1:442 NW 4TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-6491
Practice Address - Country:US
Practice Address - Phone:541-602-0260
Practice Address - Fax:541-243-4217
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2033175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath