Individual
JONATHAN N ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
10150 SE 32ND AVE, MILWAUKIE, OR 97222-6516
(503) 513-8318
Mailing address
13974 SE RED SUNSET AVE, CLACKAMAS, OR 97015-5359
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
200742985RN
OR
Other
Enumeration date
09/26/2013
Last updated
09/26/2013
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