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1013776178
NICKOLAS ROCKENBACK
PORTLAND, OR
NPI
1013776178
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-03-18
Last Update Date
2024-03-18
Business Address
NICKOLAS ROCKENBACK MD
1015 NW 22ND AVE
PORTLAND, OR 97210-3025
Phone number: 503-413-7711
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Mailing Address
NICKOLAS ROCKENBACK MD
400 SPRING ST APT 114
SAINT PAUL, MN 55102-4438
Phone number: 651-410-4621
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