Individual
ROGER DALE ROSENQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10000 SE MAIN ST, SUITE 342, PORTLAND, OR 97216-2448
(503) 255-5244
(503) 255-5120
Mailing address
501 N GRAHAM ST, SUITE 420, PORTLAND, OR 97227-1654
(503) 288-7303
(503) 288-3806
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
G25411
CA
208800000X
Urology Physician
Primary
MD12426
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135491
—
OR
Enumeration date
01/18/2007
Last updated
04/30/2009
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