Individual
NICKI LYNN ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
19250 SW 65TH AVE STE 300, TUALATIN, OR 97062-7707
(503) 692-1242
(503) 691-3615
Mailing address
7650 SW BEVELAND RD STE 200, PORTLAND, OR 97223-8692
(503) 601-3615
(503) 646-1683
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
201408658NP-PP
OR
364S00000X
Clinical Nurse Specialist
546766
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500704873
—
OR
01
—
546766
MEDICAL LICENSE
CA
Enumeration date
02/28/2008
Last updated
01/30/2026
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