Provider Demographics
NPI:1487103677
Name:GONZALES, VALERIE J (LPN)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:J
Last Name:GONZALES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:J
Other - Last Name:SNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:33330 8TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6325
Mailing Address - Country:US
Mailing Address - Phone:253-945-2086
Mailing Address - Fax:253-945-2177
Practice Address - Street 1:4014 S 270TH ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-7139
Practice Address - Country:US
Practice Address - Phone:253-945-2177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00053979164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse