Individual
ROBERT A ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2365 SW CEDAR HILLS BLVD, PORTLAND, OR 97225-4534
(503) 297-7000
Mailing address
15095 SW WEIR RD, BEAVERTON, OR 97007-6108
(971) 330-0549
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
201405725
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ME401E9R00
—
OR
Enumeration date
09/25/2017
Last updated
07/21/2022
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