Eileen M Ravella, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10005223 Issued in WA

Practice address

413 Lilly Rd NE
Providence St Peter Interventional Radiology
Olympia, WA 98506-5133

Phone

(360) 491-9480

NPI assigned

Jul 16, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eravella98297@wm.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Northwest Physician Associates PC

  • Physician Assistant
  • Arlington, WA
  • NPI 1275567919
  Medicare reassignment
• Olympia Emergency Services, PLLC

  • Emergency Medicine Physician
  • Olympia, WA
  • NPI 1346267796
  Medicare reassignment
• Providence Health & Services Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Providence Health & Services Washington

  • Rural Health Clinic/Center
  • Centralia, WA
  • NPI 1225763949
  NPD
• Peacehealth

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  NPD (past)
• Integris Ambulatory Care C Orporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1326076027
  NPD (past)
• Newkirk Rural Health Clinic

  • Family Medicine Physician
  • Newkirk, OK
  • NPI 1073538666
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1043237134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 LILLY RD NE",
            "address_2": "PROVIDENCE ST PETER INTERVENTIONAL RADIOLOGY",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065133",
            "telephone_number": "360-491-9480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1620 Cooper Point Rd SW",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985025736",
            "country_code": "US",
            "telephone_number": "360-486-6710",
            "fax_number": "360-956-1643",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Lilly Rd NE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065115",
            "country_code": "US",
            "telephone_number": "360-923-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVELLA",
        "first_name": "EILEEN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "502",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10005223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eravella98297@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1620 Cooper Point Rd SW",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985025736",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Allison Marie Raphael, RDH
• James Anders Rasband, MS SLP
• Melissa Elaine Rasmussen
• Raminder Rasode, PHARMD
• Roni Ann Rave, CDP
• Resa Eileen Raven, PSY.D.
• Leanne Frances Rawson, PT,DPT
• David Jonathon Ray, LMP
• Caitlin Quinn Rayborn, M.D.
• Dale Ann Rayburn, LPN

• Physician Assistant in Olympia, WA
• Providers in Olympia, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.