Provider Demographics
NPI:1467343749
Name:BLOMSTRA BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:BLOMSTRA BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER/CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RATUSNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-401-1085
Mailing Address - Street 1:1630 WILLIAMS HWY # 279
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5660
Mailing Address - Country:US
Mailing Address - Phone:541-596-9856
Mailing Address - Fax:541-325-4839
Practice Address - Street 1:1630 WILLIAMS HWY # 279
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5660
Practice Address - Country:US
Practice Address - Phone:541-596-9856
Practice Address - Fax:541-325-4839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty