Provider Demographics
NPI:1053886226
Name:RAGUSA, ROSEMARY K (IBCLC)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:K
Last Name:RAGUSA
Suffix:
Gender:
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11567 SE POWELL CT
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266-1762
Mailing Address - Country:US
Mailing Address - Phone:503-313-2427
Mailing Address - Fax:971-417-2112
Practice Address - Street 1:11567 SE POWELL CT
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-1762
Practice Address - Country:US
Practice Address - Phone:503-313-2427
Practice Address - Fax:971-417-2112
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-143482OtherIBCLE