Individual
KATHLEEN R ROCCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A. - C
Contact information
Practice address
5933 NE WIN SIVERS DR STE 305, PORTLAND, OR 97220-9106
(503) 420-5852
Mailing address
1600 E 32ND ST, SILVER CITY, NM 88061-7287
(575) 538-2981
(575) 388-3373
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA20080030
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01676860
—
NM
Enumeration date
11/01/2006
Last updated
10/28/2019
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