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Organization

LUKE ROSEN, DO, PLLC

Active
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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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