Provider Demographics
NPI:1629546684
Name:VILLACIAN, EUGENE DANIEL (ARNP)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:DANIEL
Last Name:VILLACIAN
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 ENSIGN RD NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5012
Mailing Address - Country:US
Mailing Address - Phone:360-493-4900
Mailing Address - Fax:
Practice Address - Street 1:3333 ENSIGN RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5012
Practice Address - Country:US
Practice Address - Phone:360-493-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60964712363L00000X
WARN60304503163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner