Most Relevant Information
Provider Data
| NPI Number: | 1003286360 |
| Provider Name: | KATHLEEN IRENE RODENBURG PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA205646 |
Most Important Dates
| Enumeration Date: | 09/30/2015 |
| Last Updated: | 12/22/2021 |
Provider Practice Location
11782 SW BARNES RD STE 300
PORTLAND
OR
972255933
Practice Location Phone/Fax
| Phone: | 5032145200 |
| Fax: | 5039066613 |
Provider Mailing Location
11782 SW BARNES RD STE 300
PORTLAND
OR
972255933
Provider Mailing Phone/Fax
| Phone: | 5032145520 |
| Fax: | 5039066613 |