Provider Demographics
NPI:1053701334
Name:PREMIER PSYCHIATRIC SERVICES, PLLC
Entity type:Organization
Organization Name:PREMIER PSYCHIATRIC SERVICES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAVASIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-919-4060
Mailing Address - Street 1:16201 E INDIANA AVE
Mailing Address - Street 2:SUITE 5300
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-2830
Mailing Address - Country:US
Mailing Address - Phone:509-919-4060
Mailing Address - Fax:509-789-9013
Practice Address - Street 1:16201 E INDIANA AVE
Practice Address - Street 2:SUITE 5300
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-2830
Practice Address - Country:US
Practice Address - Phone:509-919-4060
Practice Address - Fax:509-789-9013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty