Individual
NICOLE ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3716 NE MARTIN LUTHER KING BLVD, PORTLAND, OR 97212-1111
(502) 288-8036
Mailing address
5626 NE 36TH AVE, PORTLAND, OR 97211-7341
(503) 706-6857
(503) 706-6857
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/04/2025
Last updated
12/04/2025
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