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Individual

MS. VICTORIA LYNN VANDYKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1075 SW GRANDVIEW AVENUE, SUITE 200, GRANTS PASS, OR 97527
(541) 479-8363
(541) 476-2841
Mailing address
1075 SE GRANDVIEW AVE, STE 200, GRANTS PASS, OR 97527-5118
(360) 571-4267

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
07635952N5
OR
367A00000X
Advanced Practice Midwife
AP30003066
WA

Other

Enumeration date
09/27/2006
Last updated
01/06/2020
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