1649158973 NPI number — CATHERINE FARRELL ROGERS MA, RD, CDCES

Table of content: CATHERINE FARRELL ROGERS MA, RD, CDCES (NPI 1649158973)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649158973 NPI number — CATHERINE FARRELL ROGERS MA, RD, CDCES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROGERS
Provider First Name:
CATHERINE
Provider Middle Name:
FARRELL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, RD, CDCES
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FARRELL
Provider Other First Name:
CATHERINE
Provider Other Middle Name:
PATRICIA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1649158973
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1717 SOUTH J STREET
Provider Second Line Business Mailing Address:
MAIL STOP 01-71
Provider Business Mailing Address City Name:
TACOMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98405-4933
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-318-6815
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1717 SOUTH J STREET
Provider Second Line Business Practice Location Address:
MAIL STOP 01-07
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98405-4933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-426-4317
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/25/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  804706 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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