| David L. Raffle, Phd, Inc., A Psychological Corporation | |
|
5048 Iroquois Ave Ewa Beach HI 96706-3364 | |
| (800) 450-9799 | |
| (317) 947-1614 |
| Full Name | David L. Raffle, Phd, Inc., A Psychological Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 5048 Iroquois Ave, Ewa Beach, Hawaii |
| Authorized Official Name and Position | David L. Raffle (PRESIDENT) |
| Authorized Official Contact | 8004509799 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David L. Raffle, Phd, Inc., A Psychological Corporation 5048 Iroquois Ave Ewa Beach HI 96706-3364 Ph: (800) 450-9799 | David L. Raffle, Phd, Inc., A Psychological Corporation 5048 Iroquois Ave Ewa Beach HI 96706-3364 Ph: (800) 450-9799 |
| NPI Number | 1578991691 |
|---|---|
| Provider Enumeration Date | 10/29/2013 |
| Last Update Date | 11/06/2024 |
| Certification Date | 11/06/2024 |
| Medicare PECOS PAC ID | 3173754124 |
|---|---|
| Medicare Enrollment ID | O20181229000152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578991691 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY25732 (California) | Primary |
| Provider Name | David L. Raffle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396979514 PECOS PAC ID: 5698906642 Enrollment ID: I20181229000155 |
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