Provider Demographics
NPI:1225022270
Name:RICE, VICTORIA A (ARNP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:A
Last Name:RICE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-7154
Mailing Address - Country:US
Mailing Address - Phone:360-414-2048
Mailing Address - Fax:360-575-6749
Practice Address - Street 1:1660 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2310
Practice Address - Country:US
Practice Address - Phone:360-414-2800
Practice Address - Fax:360-414-2803
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00123941163W00000X
WAAP30003981363LX0001X, 176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9618760Medicaid
WA151802OtherLABOR & IND.
WA8930036OtherCRIME VICTIMS
OR292431Medicaid
500018605OtherRR MEDICARE
S29727Medicare UPIN
WAAB22493Medicare PIN