Provider Demographics
NPI:1457494288
Name:PERKIS, VICTORIA ANNE (ARNP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANNE
Last Name:PERKIS
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 1:611 S CHESTNUT ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-4815
Mailing Address - Country:US
Mailing Address - Phone:509-962-5437
Mailing Address - Fax:509-962-5438
Practice Address - Street 1:611 S CHESTNUT ST
Practice Address - Street 2:SUITE E
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-4815
Practice Address - Country:US
Practice Address - Phone:509-962-5437
Practice Address - Fax:509-962-5438
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003458363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARN00116364OtherRN LICENSE
WAAP30003458OtherARNP LICENSE