Provider Demographics
NPI:1699056036
Name:BUCHANAN, VICTORIA L (ARNP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3360
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3360
Mailing Address - Country:US
Mailing Address - Phone:866-366-2983
Mailing Address - Fax:
Practice Address - Street 1:12800 BOTHELL-EVERETT HWY
Practice Address - Street 2:SUITE 180
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6644
Practice Address - Country:US
Practice Address - Phone:425-316-5130
Practice Address - Fax:425-316-5131
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP60230097363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8935464Medicare UPIN