Organization
TABULA RASA ELECTROLYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL ROGERS LE (CO-OWNER)
(503) 858-8518
Entity
Organization
Contact information
Practice address
1975 NW 167TH PL STE 53, BEAVERTON, OR 97006-4908
(503) 770-0170
Mailing address
1975 NW 167TH PL STE 53, BEAVERTON, OR 97006-4908
(503) 770-0170
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
10/06/2025
Last updated
10/06/2025
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