Healthcare Provider Details

I. General information

NPI: 1225022270
Provider Name (Legal Business Name): VICTORIA A RICE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 02/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 DELAWARE ST
LONGVIEW WA
98632-2310
US

IV. Provider business mailing address

PO BOX 249
LONGVIEW WA
98632-7154
US

V. Phone/Fax

Practice location:
  • Phone: 360-414-2800
  • Fax: 360-414-2803
Mailing address:
  • Phone: 360-414-2048
  • Fax: 360-575-6749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00123941
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAP30003981
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberAP30003981
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: