Individual provider Active NPI

Gwendolyn Anne Rogers, N.D, LAC

  • Naturopath
  • Tigard, OR
National Provider Identifier
1134395221
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
1615 Issued in OR
Practice address
12570 SW 69TH Ave Ste 101
Tigard, OR 97223-2552
Phone
(503) 673-1630
Fax
(503) 691-9018
NPI assigned
May 8, 2008
Last updated
Jun 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC01269 OR
Naturopath 175F00000X 1615 OR Primary

Addresses

Primary practice location

12570 SW 69TH Ave Ste 101
Tigard, OR 97223-2552

Mailing address

PO Box 1716
Lake Oswego, OR 97035-3401
Phone (503) 673-1630

Other names 1

  • Dr. Wendy Rogers Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1615ORMDClinical Psychologist
AC01269ORMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Foundations for Health, LLC CurrentSince Jun 22, 2021 Accepting new patients

Locations

12570 SW 69th Ave
Ste 101
Tigard, OR 97223
Phone (503) 673-1630

8555 SW Tualatin Rd
Ste B
Tualatin, OR 97062
Phone (503) 691-0901

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1134395221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1716",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353401",
            "telephone_number": "503-673-1630",
            "fax_number": "503-673-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12570 SW 69TH AVE STE 101",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232552",
            "telephone_number": "503-673-1630",
            "fax_number": "503-691-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "GWENDOLYN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "N.D, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC01269",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "ROGERS",
            "prefix": "DR.",
            "credential": "N.D, LAC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.