Individual
DR. RESA EILEEN RAVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2118 CATON WAY SW, OLYMPIA, WA 98502-1105
(360) 866-8981
Mailing address
2103 HARRISON AVE NW STE 2, PMB 511, OLYMPIA, WA 98502-2607
(360) 866-8981
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
PY 60115237
WA
103TC0700X
Clinical Psychologist
Primary
PY 60115237
WA
103TF0200X
Forensic Psychologist
PY 60115237
WA
Other
Enumeration date
03/01/2012
Last updated
03/01/2012
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