Provider Demographics
NPI:1174772578
Name:RAGAIN, KERRY VICTOR (PHD)
Entity type:Individual
Prefix:DR
First Name:KERRY
Middle Name:VICTOR
Last Name:RAGAIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 80TH AVE SE STE 206
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-2975
Mailing Address - Country:US
Mailing Address - Phone:425-802-5829
Mailing Address - Fax:
Practice Address - Street 1:2955 80TH AVE SE STE 206
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-2975
Practice Address - Country:US
Practice Address - Phone:425-802-5829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00003916103T00000X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103T00000XBehavioral Health & Social Service ProvidersPsychologist