Provider Demographics
NPI:1891221859
Name:TRIETSCH, RAYNA LIN (MD)
Entity Type:Individual
Prefix:
First Name:RAYNA
Middle Name:LIN
Last Name:TRIETSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3070 S BELLAIRE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6709
Mailing Address - Country:US
Mailing Address - Phone:413-896-5466
Mailing Address - Fax:
Practice Address - Street 1:7720 S BROADWAY STE 440
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2624
Practice Address - Country:US
Practice Address - Phone:303-795-3568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODR.0065878207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program