Dr Deric V Ravsten, DO | |
621 W Madrone St Ste 330, Roseburg, OR 97470-3090 | |
(541) 672-2691 | |
(877) 284-2783 |
Full Name | Dr Deric V Ravsten |
---|---|
Gender | Male |
Speciality | Psychiatry |
Experience | 30 Years |
Location | 621 W Madrone St Ste 330, Roseburg, Oregon |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154431542 | NPI | - | NPPES |
S6444 | Other | ID | BLUE CROSS OF IDAHO |
806453300 | Medicaid | ID | |
000010154744 | Other | ID | REGENCE BLUE SHIELD OF ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | O-290 (Idaho) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Life Change Associates Pc | 8224265574 | 5 |
Entity Name | Shoshone Bannock Tribes Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801949763 PECOS PAC ID: 5496804429 Enrollment ID: O20100330001318 |
Entity Name | Life Change Associates Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598077562 PECOS PAC ID: 8224265574 Enrollment ID: O20131212001598 |
Mailing Address | Practice Location Address |
---|---|
Dr Deric V Ravsten, DO Po Box 1121, Roseburg, OR 97470-0254 Ph: (541) 672-2691 | Dr Deric V Ravsten, DO 621 W Madrone St Ste 330, Roseburg, OR 97470-3090 Ph: (541) 672-2691 |
Jerry D. Boggs, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1741 West Harvard Ave, Roseburg, OR 97471 Phone: 541-440-5320 Fax: 541-440-5322 | |
Scott Douglas Mendelson, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1813 W Harvard Avenue, Suite 201, Roseburg, OR 97471 Phone: 541-440-6390 Fax: 541-440-6392 | |
Dr. Mark Allan Ramirez, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1741 W. Harvard Ave, Roseburg, OR 97471 Phone: 541-440-5320 Fax: 541-440-5322 | |
Mia S Schreiner, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1741 W. Harvard Ave, Roseburg, OR 97471 Phone: 541-440-5320 Fax: 541-440-5322 | |
Peter James Davidson, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 2700 Stewart Parkway, Annex B, Roseburg, OR 97471 Phone: 541-440-3532 Fax: 541-440-3554 | |
Dr. James R Young, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 201 Medical Loop, Suite 180, Roseburg, OR 97471 Phone: 541-440-3532 Fax: 541-440-3554 |