Provider Demographics
NPI:1487023776
Name:ORTHMANN, VIVIAN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:
Last Name:ORTHMANN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:VIVIAN
Other - Middle Name:
Other - Last Name:CONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:504 N 40TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-4311
Mailing Address - Country:US
Mailing Address - Phone:509-966-9480
Mailing Address - Fax:
Practice Address - Street 1:504 N 40TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-4311
Practice Address - Country:US
Practice Address - Phone:509-966-9480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP 60561229363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily