Provider Demographics
NPI:1447562673
Name:GOLDSTEN, VICTORIA K (HD, LPN, LMT)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:K
Last Name:GOLDSTEN
Suffix:
Gender:F
Credentials:HD, LPN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 CONNECTICUT AVE NW STE 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-4500
Mailing Address - Country:US
Mailing Address - Phone:202-237-7681
Mailing Address - Fax:
Practice Address - Street 1:3701 CONNECTICUT AVE NW STE 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008
Practice Address - Country:US
Practice Address - Phone:202-686-8202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN8515164W00000X
MDLP12542164W00000X
HE301174H00000X
DCMT103225700000X
MDM00938225700000X
HD1001175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No174H00000XOther Service ProvidersHealth Educator
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HE301OtherHOLISTIC SERVICE AGENCY
MDM00938OtherBOARD OF MASSASGE
HD1001OtherHOLISTIC SERVICES AGENCY
DCLPN8515OtherBOARD OF NURSING
DCMT103OtherBOARD OF MASSAGE
MDLP12543OtherBOARD OF NURSING