Individual
DR. NICOLE Y ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
560 CATALINA DR STE 200, ASHLAND, OR 97520-1605
(541) 201-4850
Mailing address
560 CATALINA DR STE 200, ASHLAND, OR 97520-1605
(541) 201-4850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60964584
WA
207V00000X
Obstetrics & Gynecology Physician
MD60964584
WA
390200000X
Student in an Organized Health Care Education/Training Program
ML60677475
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD201104
OREGON DEPARTMENT OF HEALTH
OR
Enumeration date
04/25/2016
Last updated
03/12/2021
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