=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063818573
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROSE MEDICAL GROUPS, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/11/2014
-----------------------------------------------------
Last Update Date | 09/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18 NW 20TH AVE STE 101
-----------------------------------------------------
City | BATTLE GROUND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98604-4175
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-952-4457
-----------------------------------------------------
Fax | 360-828-7409
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18 NW 20TH AVE STE 101
-----------------------------------------------------
City | BATTLE GROUND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98604-4175
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-952-4457
-----------------------------------------------------
Fax | 360-828-7409
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF OPERATIONS
-----------------------------------------------------
Name | BIANCA ALVAREZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 503-952-4457
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------