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Individual

MR. VICTOR LAO DE GUZMAN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGACNP-BC, ACNPC-AG

Contact information

Practice address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-6341
(253) 761-1040
Mailing address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-6341
(253) 761-1040

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60951857
WA
363LA2100X
Acute Care Nurse Practitioner
AP138293
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
AP60951857
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2138777
WA
Enumeration date
08/07/2018
Last updated
12/02/2020
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