Healthcare Provider Details

I. General information

NPI: 1952860637
Provider Name (Legal Business Name): ALICE ROGERS OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALICE SWITZKY

II. Dates (important events)

Enumeration Date: 03/13/2019
Last Update Date: 03/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VANCOUVER PUBLIC SCHOOLS 2901 FALK RD.
VANCOUVER WA
98661
US

IV. Provider business mailing address

VANCOUVER PUBLIC SCHOOLS 2901 FALK RD.
VANCOUVER WA
98661
US

V. Phone/Fax

Practice location:
  • Phone: 360-313-1000
  • Fax:
Mailing address:
  • Phone: 360-313-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT60920491
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number411076
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: