Provider Demographics
NPI:1912188038
Name:ACKERMAN, VICTORIA DIANE (RN, IBCLC)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:DIANE
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13307 NE HIGHWAY 99 STE 105
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-3033
Mailing Address - Country:US
Mailing Address - Phone:360-253-2229
Mailing Address - Fax:
Practice Address - Street 1:13307 NE HIGHWAY 99 STE 105
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-3033
Practice Address - Country:US
Practice Address - Phone:360-253-2229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00060632163W00000X, 163WL0100X, 163WM0102X, 163WN0002X, 163WN0003X, 163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care
No163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-Risk
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient