Individual
JACQUELYN MICHELLE RODGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2474 TULANE ST, WEST LINN, OR 97068-2434
(541) 992-6100
Mailing address
2474 TULANE ST, WEST LINN, OR 97068-2434
(541) 992-6100
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1455178
OR
Other
Enumeration date
03/22/2017
Last updated
03/22/2017
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