DERIC V RAVSTEN

ROSEBURG, OR
NPI1154431542
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: ID  O-290)
Enumeration Date2006-08-30
Last Update Date2024-03-27
Business Address
Dr. DERIC V RAVSTEN D.O.
621 W MADRONE ST STE 330
ROSEBURG, OR 97470-3090
Phone number: 541-672-2691
Mailing Address
Dr. DERIC V RAVSTEN D.O.
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-672-2691