Healthcare Provider Details

I. General information

NPI: 1205303963
Provider Name (Legal Business Name): RAFE DANIEL ARLOTTI PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2018
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 W MAIN ST
BATTLE GROUND WA
98604-4311
US

IV. Provider business mailing address

PO BOX 4825
PORTLAND OR
97208-4825
US

V. Phone/Fax

Practice location:
  • Phone: 360-882-2778
  • Fax: 360-604-1762
Mailing address:
  • Phone: 360-882-2778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA61354795
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number7280
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: