Individual
VIOLA G MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
19980 10TH AVE NE STE 202, POULSBO, WA 98370-6322
(360) 979-0569
(877) 805-9505
Mailing address
PO BOX 2940, POULSBO, WA 98370-2940
(360) 979-0569
(877) 805-9505
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30004058
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039581
LABOR AND INDUSTRIES #
WA
01
—
0359072
LNI
WA
01
—
500017809
RAILROAD MC#
WA
01
—
7793ME
BLUE SHIELD #
WA
05
—
9619594
—
WA
01
—
US2510511
AETNA SPECIALIST PIN
WA
Enumeration date
01/25/2007
Last updated
04/10/2019
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