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Mikaela Lea Rodriguez

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

PECOS Enrollment

This provider is enrolled in PECOS as MIKAELA RODRIGUEZ.

Based on the most recent information from CMS, provider Mikaela Lea Rodriguez is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1043674401
Provider Type
Individual
Full Name
Rodriguez, Mikaela Lea
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
4/11/2016
Last Updated
6/23/2020

Contact Information

Practice Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 494-8211

Unlisted Fax

Mailing Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098

(503) 494-6176

(503) 494-6152

Provider Taxonomies

Code	Description	License
Code 2084P0800X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License MD19950 Oregon

Mikaela Lea Rodriguez

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Chung, Janice

Nagarkatti-Gude, David Roberto De Vela

Hoffman, William Franklin

Matthews, Annette Marie

Starr, Kathryn

Masolak, David Damian

Kennedy, Donald Louis

Schmick, Elizabeth Ann

Fireman, Marian

Tacker, Katherine Ann