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General NPI Number Information
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NPI Number | 1093438368
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Entity Type | Organization
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Legal Business Name | RAPHA PSYCHIATRY LLC
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Dates
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Enumeration Date | 09/22/2022
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 1752 NW MARKET ST # 4741
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City | SEATTLE
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State | WA
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Zip | 98107-5264
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Country | US
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Telephone | 562-388-2782
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Fax |
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Provider Business Mailing Address
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Address Line | 3453 LA SOLANA AVE
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City | CLOVIS
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State | CA
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Zip | 93619-7232
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANTHONIA OKPALA
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Credential |
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Telephone | 562-388-2782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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