Provider Demographics
NPI:1346778008
Name:CARLSON, VICTORIA LYNN (RN)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:LYNN
Last Name:CARLSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23911 24TH DR SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-9649
Mailing Address - Country:US
Mailing Address - Phone:425-770-8569
Mailing Address - Fax:425-463-4274
Practice Address - Street 1:23911 24TH DR SE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-9649
Practice Address - Country:US
Practice Address - Phone:425-770-8569
Practice Address - Fax:425-463-4274
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00064340163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health