Provider Demographics
NPI:1063818573
Name:ROSE MEDICAL GROUPS, PC
Entity type:Organization
Organization Name:ROSE MEDICAL GROUPS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-952-4457
Mailing Address - Street 1:18 NW 20TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-4226
Mailing Address - Country:US
Mailing Address - Phone:360-952-4457
Mailing Address - Fax:360-828-7409
Practice Address - Street 1:18 NW 20TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-4175
Practice Address - Country:US
Practice Address - Phone:360-952-4457
Practice Address - Fax:360-828-7409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-11
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA261QU0200X
261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care