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Individual

KATHLEEN RAFTERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
200 NE MOTHER JOSEPH PL STE 330, VANCOUVER, WA 98664-3288
(360) 514-2990
(360) 514-3508
Mailing address
4438 HIDEAWAY PL, LA MESA, CA 91941-6800

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA61285554
WA
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
MED-PAC-REG-0001782
MT
363AS0400X
Surgical Physician Assistant
Primary
MED-PAC-LIC-91166
MT

Other

Enumeration date
03/10/2016
Last updated
05/01/2024
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