MEDICARE: RAVEN SCRIVNER

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	172V00000X	Community Health Worker		WA

General Provider Information

NPI Number	:	1932070133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAVEN SCRIVNER

Provider Business Mailing Address
First Line	:	PO BOX 1221
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98507-1221
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	161 PATTISON ST NE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98506-4954
Country	:	US
Telephone Number	:	360-357-7224
Fax Number	:

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

Provider Enumeration Date	:	09/12/2025
Last Update Date	:	09/12/2025

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Directions to “ RAVEN SCRIVNER ” Practice Location

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