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NPI Code Detail

MEDICARE: NICOLE ROGERS

MEDICARE: NICOLE ROGERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1821951088
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE ROGERS
Provider Business Mailing Address
First Line : 5626 NE 36TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97211-7341
Country : US
Telephone Number : 503-706-6857
Fax Number : 503-706-6857
Provider Business Practice Location Address
First Line : 3716 NE MARTIN LUTHER KING BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97212-1111
Country : US
Telephone Number : 502-288-8036
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2025
Last Update Date : 12/04/2025

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Directions to “ NICOLE ROGERS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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