Individual
MS. BEVERLY NAN ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
543 MAIN ST STE E, EDMONDS, WA 98020-3162
(206) 335-3174
Mailing address
22707 76TH AVE W APT 226, EDMONDS, WA 98026-8497
(206) 286-7761
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA-3033
WA
172V00000X
Community Health Worker
MA-3033
WA
Other
Enumeration date
05/31/2013
Last updated
05/31/2013
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