Provider Demographics
NPI:1841382751
Name:ROGERS, MARJORIE L (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:L
Last Name:ROGERS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 GEORGE WASHINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4211
Mailing Address - Country:US
Mailing Address - Phone:509-946-9200
Mailing Address - Fax:509-943-0649
Practice Address - Street 1:706 GEORGE WASHINGTON WAY
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4211
Practice Address - Country:US
Practice Address - Phone:509-946-9200
Practice Address - Fax:509-943-0649
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00002468225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA115388OtherDEPT OF LABOR & INDUSTRIE
1813969OtherUNITED HEALTHCARE
14390169OtherLUMENOS
RO8108OtherREGENCE
4405630001OtherDMERC REGION D
RO8108OtherREGENCE