Provider Demographics
NPI:1881955771
Name:BETZA, RAFFAELLA SAPPE (MD)
Entity type:Individual
Prefix:DR
First Name:RAFFAELLA
Middle Name:SAPPE
Last Name:BETZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3290
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-7290
Mailing Address - Country:US
Mailing Address - Phone:541-437-2273
Mailing Address - Fax:541-437-8585
Practice Address - Street 1:570 S 8TH AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:OR
Practice Address - Zip Code:97827-9726
Practice Address - Country:US
Practice Address - Phone:541-437-2273
Practice Address - Fax:541-437-8585
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML60293634207Q00000X
ORMD175611207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine