Individual
DR. LICIA LYNN RAYMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
751 NE BLAKELY DR STE 2030, ISSAQUAH, WA 98029-6201
(425) 313-7080
(425) 313-7071
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7643
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
238127
MA
207V00000X
Obstetrics & Gynecology Physician
Primary
MD60660120
WA
207VG0400X
Gynecology Physician
4301055550
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2170728
—
MA
Enumeration date
07/14/2006
Last updated
07/21/2022
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