Provider Demographics
NPI:1639329758
Name:BATCHELOR, ROGER P (DAOM)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:P
Last Name:BATCHELOR
Suffix:
Gender:M
Credentials:DAOM
Other - Prefix:
Other - First Name:ROGER
Other - Middle Name:BATCHELOR
Other - Last Name:LORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DAOM
Mailing Address - Street 1:1818 SW STEPHENSON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-8240
Mailing Address - Country:US
Mailing Address - Phone:503-208-5183
Mailing Address - Fax:
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239
Practice Address - Country:US
Practice Address - Phone:503-494-8311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC000111171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist