MEDICARE: ALEXA RAEYNE RAMSDELL

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	171M00000X	Case Manager/Care Coordinator		WA
2	175T00000X	Peer Specialist		WA

General Provider Information

NPI Number	:	1619456480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXA RAEYNE RAMSDELL

Provider Business Mailing Address
First Line	:	707 N PEARL ST
Second Line	:
City	:	ELLENSBURG
State	:	WA
Zip	:	98926-2938
Country	:	US
Telephone Number	:	509-925-7507
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 N PEARL ST
Second Line	:
City	:	ELLENSBURG
State	:	WA
Zip	:	98926-2938
Country	:	US
Telephone Number	:	509-925-7507
Fax Number	:

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

Provider Enumeration Date	:	08/12/2018
Last Update Date	:	03/10/2026

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