Provider Demographics
NPI:1467205104
Name:RAPH'S HEALING HEALTH CARE
Entity Type:Organization
Organization Name:RAPH'S HEALING HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:(PMHNP-BC)
Authorized Official - Prefix:MR
Authorized Official - First Name:RAPHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MPRAH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MSN, PMHNP
Authorized Official - Phone:347-303-6390
Mailing Address - Street 1:5904 59TH DR NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-9001
Mailing Address - Country:US
Mailing Address - Phone:347-303-6390
Mailing Address - Fax:
Practice Address - Street 1:522 W RIVERSIDE AVE STE N
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0580
Practice Address - Country:US
Practice Address - Phone:347-303-6390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty