Individual
SOPHIA C RAEVOURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
752 OFFICERS ROW, VANCOUVER, WA 98661-3845
(360) 996-1071
(360) 938-5632
Mailing address
2807 N PIONEER CANYON DR, RIDGEFIELD, WA 98642-7524
(609) 961-0713
(360) 938-5632
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61370244
WA
Other
Enumeration date
01/15/2022
Last updated
05/07/2025
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