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1154431542
DERIC V RAVSTEN
ROSEBURG, OR
NPI
1154431542
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: ID O-290)
Enumeration Date
2006-08-30
Last Update Date
2024-03-27
Business Address
Dr. DERIC V RAVSTEN D.O.
621 W MADRONE ST STE 330
ROSEBURG, OR 97470-3090
Phone number: 541-672-2691
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Mailing Address
Dr. DERIC V RAVSTEN D.O.
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-672-2691
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