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NPI Code Detail

MEDICARE: RAVEN OSTEEN

MEDICARE: RAVEN OSTEEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1104309228
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAVEN OSTEEN
Provider Business Mailing Address
First Line : 7440 W MARGINAL WAY S
Second Line :
City : SEATTLE
State : WA
Zip : 98108-4141
Country : US
Telephone Number : 509-503-6010
Fax Number :
Provider Business Practice Location Address
First Line : 1302 W GARDNER AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99201-2059
Country : US
Telephone Number : 509-503-6010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2018
Last Update Date : 04/07/2023

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Directions to “ RAVEN OSTEEN ” Practice Location

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