Individual provider · NPI-1
Katty Raisor, ARNP
Nurse Practitioner, Family · Rochester, WA
NPI number1104695485
StatusActive
Last updated in NPPESOct 1, 2024
Details
- NPI
- 1104695485
- Entity type
- Individual (NPI-1)
- Name
- Katty Raisor
- Credential
- ARNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 27, 2023
- Certification date
- Oct 1, 2024
- Last updated
- Oct 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | AP61511127 | WA | Yes |
Practice location
18313 Paulson St Sw Ste ARochester, WA 98579-9262
Phone 360-827-8400 · Fax 360-273-7301
Mailing address
Po Box 3360Portland, OR 97208-3360
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