Provider Demographics
NPI:1447878848
Name:RAABE, ASHLEIGH
Entity type:Individual
Prefix:MS
First Name:ASHLEIGH
Middle Name:
Last Name:RAABE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2545 N NARROWS DR APT 2110
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-2303
Mailing Address - Country:US
Mailing Address - Phone:360-286-6432
Mailing Address - Fax:
Practice Address - Street 1:7502 LAKEWOOD DR W STE D
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-8410
Practice Address - Country:US
Practice Address - Phone:253-588-4344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-12
Last Update Date:2020-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC60810760376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
WANC60810760OtherNURSING ASSISTANT CREDITIAL