Provider Demographics
NPI:1902414451
Name:ROGERS, PATRICIA KAY (DNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:KAY
Last Name:ROGERS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 PACIFIC AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-4381
Mailing Address - Country:US
Mailing Address - Phone:936-648-8893
Mailing Address - Fax:
Practice Address - Street 1:1201 PACIFIC AVE STE 400
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-4381
Practice Address - Country:US
Practice Address - Phone:253-300-8453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA36118439363L00000X
WARN61168978163W00000X
WAAP61168985363LA2200X, 363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology