Individual
JONATHAN MARK VANRAVENSWAAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3521 MOUNTAIN VIEW DR, ANCHORAGE, AK 99508-1111
(805) 766-1049
Mailing address
PO BOX 140968, ANCHORAGE, AK 99514-0968
(805) 766-1049
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
111160
AK
207Q00000X
Family Medicine Physician
A133945
CA
Other
Enumeration date
05/24/2013
Last updated
11/10/2023
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