Healthcare Provider Details

I. General information

NPI: 1912063256
Provider Name (Legal Business Name): ROSA M. GARCIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSA M GARCIA-JORDAN

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15950 SW MILLIKAN WAY
BEAVERTON OR
97003-5170
US

IV. Provider business mailing address

16961 SW DELINE CT
BEAVERTON OR
97007-5260
US

V. Phone/Fax

Practice location:
  • Phone: 503-646-0161
  • Fax:
Mailing address:
  • Phone: 650-537-9504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD26310
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD26310
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: