Provider Demographics
NPI:1366859175
Name:GOMES, VICTOR (ARNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:GOMES
Suffix:
Gender:M
Credentials:ARNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 MAIN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-2963
Mailing Address - Country:US
Mailing Address - Phone:425-600-1395
Mailing Address - Fax:425-842-4904
Practice Address - Street 1:1220 MAIN ST STE 400
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-2963
Practice Address - Country:US
Practice Address - Phone:425-464-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-14
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61421622363LP0808X
OR201403830RN163WP0808X
171M00000X
OR10006901363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator