Individual
EILEEN M RAVELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
413 LILLY RD NE, PROVIDENCE ST PETER INTERVENTIONAL RADIOLOGY, OLYMPIA, WA 98506-5133
(360) 491-9480
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
502
OK
363A00000X
Physician Assistant
Primary
PA10005223
WA
Other
Enumeration date
07/16/2006
Last updated
06/16/2021
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