Provider Demographics
NPI:1619118031
Name:STENKAMP, VICTORIA SUSAN (LMP)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:SUSAN
Last Name:STENKAMP
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MS
Other - First Name:SUSIE
Other - Middle Name:
Other - Last Name:STENKAMP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:315 SPOKANE ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-1952
Mailing Address - Country:US
Mailing Address - Phone:509-531-2025
Mailing Address - Fax:509-371-8087
Practice Address - Street 1:315 SPOKANE ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-1952
Practice Address - Country:US
Practice Address - Phone:509-531-2025
Practice Address - Fax:509-371-8087
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-14
Last Update Date:2009-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60021988172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist