Provider Demographics
NPI:1083031132
Name:OTTESON, RAUNA R (CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:RAUNA
Middle Name:R
Last Name:OTTESON
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18815 NW NELSCOTT ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-3211
Mailing Address - Country:US
Mailing Address - Phone:971-998-8007
Mailing Address - Fax:
Practice Address - Street 1:18815 NW NELSCOTT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-3211
Practice Address - Country:US
Practice Address - Phone:971-998-8007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10069374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula