Individual
MICHAEL RAVELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
421 S DIVISION ST, SPOKANE, WA 99202-1331
(509) 474-2100
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(509) 474-2100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125058658
IL
207Q00000X
Family Medicine Physician
Primary
MD60586394
WA
Other
Enumeration date
06/15/2010
Last updated
11/25/2015
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