Provider Demographics
NPI:1669705760
Name:RADABAUGH, VICTORIA ANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:ANNE
Last Name:RADABAUGH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:MCKEEVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:16770 NE 79TH ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-4413
Mailing Address - Country:US
Mailing Address - Phone:206-550-8241
Mailing Address - Fax:
Practice Address - Street 1:16770 NE 79TH ST
Practice Address - Street 2:SUITE 204
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4413
Practice Address - Country:US
Practice Address - Phone:206-550-8241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002981103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling