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Individual

CHANCE RAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2364
(509) 474-3131
Mailing address
1113 E ADELINE AVE, COEUR D ALENE, ID 83814-4426

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN60786152
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
2861260
ID
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/14/2021
Last updated
10/09/2024
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