Healthcare Provider Details

I. General information

NPI: 1326843160
Provider Name (Legal Business Name): HAVEN M RAINER BSN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 02/17/2025
Certification Date: 02/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W 5TH AVE
SPOKANE WA
99204-2803
US

IV. Provider business mailing address

PO BOX 253
VALLEY WA
99181-0253
US

V. Phone/Fax

Practice location:
  • Phone: 509-603-5800
  • Fax:
Mailing address:
  • Phone: 509-936-2583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN61510992
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: