Healthcare Provider Details

I. General information

NPI: 1558342758
Provider Name (Legal Business Name): JOSEPH RAAP M.A
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 NE 5TH AVE
CAMAS WA
98607-2007
US

IV. Provider business mailing address

605 NE 5TH AVE
CAMAS WA
98607-2007
US

V. Phone/Fax

Practice location:
  • Phone: 360-833-0609
  • Fax: 360-833-0622
Mailing address:
  • Phone: 360-833-0609
  • Fax: 360-833-0622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberLD00001396
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: