MEDICARE: GURMU DHAAYE RAGASSA RN, BSN

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
1	163W00000X	Registered Nurse	70003788	WA

General Provider Information

NPI Number	:	1033070156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GURMU DHAAYE RAGASSA RN, BSN

Provider Business Mailing Address
First Line	:	2511 NW 15TH WAY
Second Line	:
City	:	BATTLE GROUND
State	:	WA
Zip	:	98604-4186
Country	:	US
Telephone Number	:	360-723-0456
Fax Number	:	360-723-0248

Provider Business Practice Location Address
First Line	:	2511 NW 15TH WAY
Second Line	:
City	:	BATTLE GROUND
State	:	WA
Zip	:	98604-4186
Country	:	US
Telephone Number	:	360-723-0456
Fax Number	:	360-723-0248

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2025
Last Update Date	:	11/19/2025

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