Individual
VIRGINIA FAIR OLDFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
33811 9TH AVE S, FEDERAL WAY, WA 98003-6707
(425) 446-1168
Mailing address
14503 PORTLAND AVE SW, LAKEWOOD, WA 98498-5130
(425) 446-1168
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60185463
WA
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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