Individual
TODD MICHAEL ROSBOROUGH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
135 NE 102ND AVE, PORTLAND, OR 97220-4167
(503) 255-5388
(503) 255-5085
Mailing address
135 NE 102ND AVE, PORTLAND, OR 97220-4167
(503) 255-5388
(503) 255-5085
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00576
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0131007
WA LABOR INDUSTRIES
WA
Enumeration date
11/10/2005
Last updated
07/08/2007
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