Raven Acupuncture PLLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

60807373 Issued in WA

Legal business name

RAVEN ACUPUNCTURE PLLC

Practice address

120 NE 117TH Ave
Vancouver, WA 98684-5020

Phone

(503) 987-0574

NPI assigned

Mar 18, 2018

Last updated

Mar 18, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sarah Wickstrom, LACNPI 1174868251

Title

Acupuncturist

Phone

(303) 912-5401

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sarah Jo Wickstrom, LAC

  • Acupuncturist
  • West Linn, OR
  • NPI 1174868251
  NPD Authorized official

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

{
    "created_epoch": "1521331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521331200000",
    "number": "1548763352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36824 SE SUNSET VIEW RD",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986716769",
            "telephone_number": "303-912-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NE 117TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845020",
            "telephone_number": "503-987-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVEN ACUPUNCTURE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-18",
        "last_updated": "2018-03-18",
        "status": "A",
        "authorized_official_last_name": "WICKSTROM",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "ACUPUNCTURIST",
        "authorized_official_telephone_number": "303-912-5401",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "60807373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500679284",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah A Ratkoviak, RNFA
• Ashli Ratliff
• Lanette Raugust
• Riley Raugust
• Jordan Renee Rautio
• Haritha Ravi, MD
• Sarah Ravnaas, THERAPIST
• Kelly Michelle Rawhouser
• Nikolas Edward Rawley, D.M.D.
• Theresa Rosalyn Rawson, CDP

• Acupuncturist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Acupuncturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2018; 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.