Organization
LUKE ROSEN, DO, PLLC
Active
Other names
PsychNS
Organization subpart
No
Provider details
NPI number
Authorized official
LUKE BILLMEYER ROSEN DO (OWNER)
(360) 828-8130
Entity
Organization
Contact information
Practice address
1174 ALTURAS DR UNIT 4B, MOSCOW, ID 83843-8341
(360) 828-8130
(360) 785-2171
Mailing address
1174 ALTURAS DR UNIT 4B, MOSCOW, ID 83843-8341
(360) 828-8130
(360) 785-2171
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
OP60447877
WA
2084P0800X
Psychiatry Physician
OP60447877
WA
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
07/24/2018
Last updated
09/30/2022
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