Provider Demographics
NPI:1124207857
Name:BOIVIN, VICTORIA D (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:D
Last Name:BOIVIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:VICTORIA
Other - Middle Name:D
Other - Last Name:REINHOLZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:605 5TH AVE S
Mailing Address - Street 2:#150
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3886
Mailing Address - Country:US
Mailing Address - Phone:206-462-4859
Mailing Address - Fax:206-223-7926
Practice Address - Street 1:605 5TH AVE S
Practice Address - Street 2:#150
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3886
Practice Address - Country:US
Practice Address - Phone:206-462-4859
Practice Address - Fax:206-223-7926
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007943363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily