Individual
VICTORIA WAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5015 HANNEGAN RD, BELLINGHAM, WA 98226-9754
(360) 398-2582
Mailing address
5015 HANNEGAN RD, BELLINGHAM, WA 98226-9754
(360) 398-2582
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
753492
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
753492
ADULT FAMILY HOME
WA
05
—
753492
—
WA
Enumeration date
12/07/2017
Last updated
12/07/2017
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