Provider Demographics
NPI:1740306380
Name:ROGERS, PATRICIA H (MS-CCC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:H
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MS-CCC
Other - Prefix:MRS
Other - First Name:TRICIA
Other - Middle Name:H
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS-CCC
Mailing Address - Street 1:8196 SW HALL BLVD
Mailing Address - Street 2:#114
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-6409
Mailing Address - Country:US
Mailing Address - Phone:503-641-2005
Mailing Address - Fax:503-641-0833
Practice Address - Street 1:8196 SW HALL BLVD
Practice Address - Street 2:#114
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-6409
Practice Address - Country:US
Practice Address - Phone:503-641-2005
Practice Address - Fax:503-641-0833
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11948235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist