| Raven Medicine Llc | |
|
35951 Abbie Ln Astoria OR 97103-8101 | |
| (503) 468-8832 | |
| Not Available |
| Full Name | Raven Medicine Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 35951 Abbie Ln, Astoria, Oregon |
| Authorized Official Name and Position | Robin Lea Kenning (OWNER/ NP) |
| Authorized Official Contact | 4699903826 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Raven Medicine Llc 35951 Abbie Ln Astoria OR 97103-8101 Ph: (503) 468-8832 | Raven Medicine Llc 35951 Abbie Ln Astoria OR 97103-8101 Ph: (503) 468-8832 |
| NPI Number | 1225896111 |
|---|---|
| Provider Enumeration Date | 03/06/2024 |
| Last Update Date | 03/06/2024 |
| Certification Date | 03/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225896111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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