Individual
MICAH ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1460 NE PARK LN, FAIRVIEW, OR 97024-3837
(503) 936-7617
Mailing address
1460 NE PARK LN, FAIRVIEW, OR 97024-3837
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
—
—
Other
Enumeration date
04/29/2025
Last updated
04/29/2025
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