Provider Demographics
NPI:1023733771
Name:TOOLEY, VICTORIA DAWN (MA 60459306)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:DAWN
Last Name:TOOLEY
Suffix:
Gender:F
Credentials:MA 60459306
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1087 LEWIS RIVER RD # 366
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98674-9689
Mailing Address - Country:US
Mailing Address - Phone:360-773-3459
Mailing Address - Fax:
Practice Address - Street 1:566 GOERIG ST # B
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:WA
Practice Address - Zip Code:98674-9442
Practice Address - Country:US
Practice Address - Phone:360-773-3459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60459306225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist