Provider Demographics
NPI:1275674947
Name:RAAB, EARNEST LEE (DC)
Entity Type:Individual
Prefix:
First Name:EARNEST
Middle Name:LEE
Last Name:RAAB
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W. 515 FRANCIS AVE.,
Mailing Address - Street 2:STE 1
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6413
Mailing Address - Country:US
Mailing Address - Phone:509-327-8005
Mailing Address - Fax:509-327-7869
Practice Address - Street 1:W. 515 FRANCIS AVE.,
Practice Address - Street 2:STE 1
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6413
Practice Address - Country:US
Practice Address - Phone:509-327-8005
Practice Address - Fax:509-327-7869
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001411111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0061881OtherLABOR AND INDUSTRIES
759350261OtherRAILROAD MEDICARE
RAABE04383600OtherBLUE CROSS
RAABE04383600OtherBLUE CROSS