Basic Information
| Provider Information | |||||||||
| NPI: | 1225022270 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RICE | ||||||||
| FirstName: | VICTORIA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 249 | ||||||||
| Address2: | |||||||||
| City: | LONGVIEW | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986327154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604142048 | ||||||||
| FaxNumber: | 3605756749 | ||||||||
| Practice Location | |||||||||
| Address1: | 1660 DELAWARE ST | ||||||||
| Address2: | |||||||||
| City: | LONGVIEW | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986322310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604142800 | ||||||||
| FaxNumber: | 3604142803 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2005 | ||||||||
| LastUpdateDate: | 02/17/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN00123941 | WA | N | Nursing Service Providers | Registered Nurse | 363LX0001X | AP30003981 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology | 176B00000X | AP30003981 | WA | N | Other Service Providers | Midwife |
ID Information
| ID | Type | State | Issuer | Description | 9618760 | 05 | WA | MEDICAID | 151802 | 01 | WA | LABOR & IND. | OTHER | 8930036 | 01 | WA | CRIME VICTIMS | OTHER | 292431 | 05 | OR | MEDICAID | 500018605 | 01 | RR MEDICARE | OTHER |