Provider Demographics
NPI:1508743618
Name:VICTORY SENIOR CARE
Entity type:Organization
Organization Name:VICTORY SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEWABECH
Authorized Official - Middle Name:Z
Authorized Official - Last Name:YOHANES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-696-9431
Mailing Address - Street 1:7818 E CASINO RD
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-6550
Mailing Address - Country:US
Mailing Address - Phone:206-696-9431
Mailing Address - Fax:
Practice Address - Street 1:7818 E CASINO RD
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-6550
Practice Address - Country:US
Practice Address - Phone:206-696-9431
Practice Address - Fax:425-513-5772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376G00000XNursing Service Related ProvidersNursing Home AdministratorGroup - Single Specialty