Provider Demographics
NPI:1053864769
Name:POWERS, VICTORIA GOLDEN (RN)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:GOLDEN
Last Name:POWERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:VICTORIA
Other - Middle Name:ANNA
Other - Last Name:GOLDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4615 N FERDINAND ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-4412
Mailing Address - Country:US
Mailing Address - Phone:206-550-0847
Mailing Address - Fax:
Practice Address - Street 1:4615 N FERDINAND ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-4412
Practice Address - Country:US
Practice Address - Phone:206-550-0847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60427411163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse