Provider Demographics
NPI:1033789474
Name:AASE, VICTORIA PACKARD (RN)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:PACKARD
Last Name:AASE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:PACKARD
Other - Last Name:AASR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:813 N 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:KELSO
Mailing Address - State:WA
Mailing Address - Zip Code:98626-4817
Mailing Address - Country:US
Mailing Address - Phone:360-430-8033
Mailing Address - Fax:
Practice Address - Street 1:813 N 16TH AVE
Practice Address - Street 2:
Practice Address - City:KELSO
Practice Address - State:WA
Practice Address - Zip Code:98626-4817
Practice Address - Country:US
Practice Address - Phone:360-430-8033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00114692163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse