Healthcare Provider Details

I. General information

NPI: 1902989288
Provider Name (Legal Business Name): CATHERINE A ROJO PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 12/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 NE CUSHING DR STE 100
BEND OR
97701-3887
US

IV. Provider business mailing address

1303 NE CUSHING DR STE 100
BEND OR
97701-3887
US

V. Phone/Fax

Practice location:
  • Phone: 541-388-2333
  • Fax: 541-388-0930
Mailing address:
  • Phone: 541-388-2333
  • Fax: 541-388-0930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA00797
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code364SM0705X
TaxonomyMedical-Surgical Clinical Nurse Specialist
License NumberPA503
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberPA00797
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: