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NPI Code Detail

MEDICARE: GREGORY B RAAPPANA P.A.-C

MEDICARE: GREGORY B RAAPPANA P.A.-C
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
1363A00000XPhysician AssistantPA10003577WA

General Provider Information

NPI Number : 1144250572
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY B RAAPPANA P.A.-C
Provider Business Mailing Address
First Line : PO BOX 3360
Second Line : SUITE 220
City : PORTLAND
State : OR
Zip : 97208-3360
Country : US
Telephone Number : 360-486-6508
Fax Number :
Provider Business Practice Location Address
First Line : 615 LILLY RD NE STE 220
Second Line : PMG SW WA NEUROSURGERY
City : OLYMPIA
State : WA
Zip : 98506-5137
Country : US
Telephone Number : 360-486-6150
Fax Number : 360-486-6155
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 05/08/2015

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