Provider Demographics
NPI:1841673670
Name:ROCHLIN, MICHAEL (RN)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:ROCHLIN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 NW 19TH AVE
Mailing Address - Street 2:APT 610
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-2088
Mailing Address - Country:US
Mailing Address - Phone:206-427-1048
Mailing Address - Fax:
Practice Address - Street 1:550 NW 19TH AVE
Practice Address - Street 2:APT 610
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2088
Practice Address - Country:US
Practice Address - Phone:206-427-1048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-29
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201143536RN163WC0400X, 163WP0000X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WP0000XNursing Service ProvidersRegistered NursePain Management
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care