Individual
DEREK KNIGHT ROGALSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-5151
Mailing address
3181 SW SAM JACKSON PARK RD, OHSU, PORTLAND, OR 97239
(503) 494-8211
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD196450
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2015
Last updated
04/30/2020
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