Provider Demographics
NPI:1588759294
Name:LINCOLN, VALERA JANE
Entity type:Individual
Prefix:MS
First Name:VALERA
Middle Name:JANE
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:VALERA
Other - Middle Name:JANE
Other - Last Name:LINCOLN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1660 S COLUMBIAN WAY
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1532
Mailing Address - Country:US
Mailing Address - Phone:206-277-1643
Mailing Address - Fax:
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-764-2199
Practice Address - Fax:206-764-2922
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00149403163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse