Individual
MR. TIMOTHY J ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
209 NW 2ND ST, NEWPORT, OR 97365-3756
(541) 378-5309
Mailing address
209 NW 2ND ST, NEWPORT, OR 97365-3756
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C4026
OR
172V00000X
Community Health Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500704910
—
OR
Enumeration date
07/30/2012
Last updated
09/25/2020
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