Organization Active NPI

Raphael Recovery and Support LLC

  • Psychiatry Physician
  • Olympia, WA
National Provider Identifier
1578375879
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
RAPHAEL RECOVERY AND SUPPORT LLC
Practice address
2024 Caton Way SW
Olympia, WA 98502-8201
Phone
(657) 767-4837
Fax
(800) 507-2906
NPI assigned
Jan 23, 2025
Last updated
Sep 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Authorized official

Name
Maria Valdenegro
Title
Owner
Phone
(406) 461-0960

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

2024 Caton Way SW
Olympia, WA 98502-8201

Mailing address

2024 Caton Way SW Ste 203
Olympia, WA 98502-8210
Phone (657) 767-4837

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250218000791 WA Part B Supplier - Clinic/Group Practice 3173043429 Receives reassigned benefits from 3 practitioners
Practice locations: Olympia, WA

National Provider Directory

National Provider Directory

Locations

2024 Caton Way SW
Olympia, WA 98502
Phone (360) 358-1506

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1578375879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 CATON WAY SW STE 203",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028210",
            "telephone_number": "657-767-4837",
            "fax_number": "800-507-2906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 CATON WAY SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028201",
            "telephone_number": "657-767-4837",
            "fax_number": "800-507-2906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAPHAEL RECOVERY AND SUPPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-23",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A",
        "authorized_official_last_name": "VALDENEGRO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-461-0960"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.