Individual
KATIE LEIGH ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
2143 NE BROADWAY ST # 9, PORTLAND, OR 97232-1512
(971) 259-3759
(971) 402-9020
Mailing address
607 SE 17TH AVE APT 7, PORTLAND, OR 97214-2600
(971) 259-3759
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10186235
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86085814
COMMISSION ON DIETETIC REGISTRATION
—
01
—
DI61358765
STATE LICENSURE WA
WA
01
—
LD-D-10186235
STATE LICENSE NUMBER
OR
Enumeration date
04/04/2019
Last updated
12/07/2022
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