Provider Demographics
NPI:1588135172
Name:LIVINGSTON, VICTORIA A (MA)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:A
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 W HOWE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-2956
Mailing Address - Country:US
Mailing Address - Phone:206-632-9884
Mailing Address - Fax:
Practice Address - Street 1:820 W HOWE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-2956
Practice Address - Country:US
Practice Address - Phone:206-632-9884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-08
Last Update Date:2018-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health