JONATHAN MARK VANRAVENSWAAY

ANCHORAGE, AK
NPI1154768588
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: AK  111160)
Additional Taxonomies207Q00000X Family Medicine
(Licence: CA  A133945)
Enumeration Date2013-05-24
Last Update Date2023-11-10
Business Address
JONATHAN MARK VANRAVENSWAAY MD
3521 MOUNTAIN VIEW DR
ANCHORAGE, AK 99508-1111
Phone number: 805-766-1049
Mailing Address
JONATHAN MARK VANRAVENSWAAY MD
PO BOX 140968
ANCHORAGE, AK 99514-0968
Phone number: 805-766-1049