MEDICARE: VICTORS OF NIGHTINGALE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1114877974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VICTORS OF NIGHTINGALE LLC

Provider Business Mailing Address
First Line	:	31224 PETE VON REICHBAUER WAY S APT D101
Second Line	:
City	:	FEDERAL WAY
State	:	WA
Zip	:	98003-5493
Country	:	US
Telephone Number	:	253-733-6614
Fax Number	:

Provider Business Practice Location Address
First Line	:	31224 PETE VON REICHBAUER WAY S APT D101
Second Line	:
City	:	FEDERAL WAY
State	:	WA
Zip	:	98003-5493
Country	:	US
Telephone Number	:	253-733-6614
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	VICTOR OCHIENG
Credential	:
Telephone Number	:	253-733-6614

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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