Individual provider Active NPI

Roni Ann Rave, CDP

  • Specialist
  • Olympia, WA
National Provider Identifier
1467612440
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
CP00003585 Issued in WA
Practice address
4816 She Nah Num Dr SE
Olympia, WA 98513-9105
Phone
(360) 459-5312
NPI assigned
Jun 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X CP00003585 WA Primary

Addresses

Primary practice location

4816 She Nah Num Dr SE
Olympia, WA 98513-9105

Mailing address

4816 She Nah Num Dr SE
Olympia, WA 98513-9105
Phone (360) 459-5312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CP00003585WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1467612440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4816 SHE NAH NUM DR SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985139105",
            "telephone_number": "360-459-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4816 SHE NAH NUM DR SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985139105",
            "telephone_number": "360-459-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVE",
        "first_name": "RONI",
        "middle_name": "ANN",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "CP00003585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.