Provider Demographics
NPI:1114746633
Name:LEWIS, VALERIE JO (RN)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:JO
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1439 MOUNTAIN VIEW LN
Mailing Address - Street 2:
Mailing Address - City:ZILLAH
Mailing Address - State:WA
Mailing Address - Zip Code:98953-9154
Mailing Address - Country:US
Mailing Address - Phone:509-930-6252
Mailing Address - Fax:
Practice Address - Street 1:409 N 2ND ST
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-2336
Practice Address - Country:US
Practice Address - Phone:509-576-0800
Practice Address - Fax:509-530-2852
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00129737163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health