Individual provider Active NPI

Vicki Lee Lucht, LPN

  • Licensed Practical Nurse
  • Centralia, WA
National Provider Identifier
1205469103
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP00034331 Issued in WA
Practice address
3510 Steelhammer Dr # 3
Centralia, WA 98531-4551
Phone
(360) 388-0775
NPI assigned
Feb 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP00034331 WA Primary

Addresses

Primary practice location

3510 Steelhammer Dr # 3
Centralia, WA 98531-4551

Mailing address

3510 Steelhammer Dr # 3
Centralia, WA 98531-4551
Phone (360) 388-0775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP00034331WAMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1205469103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 STEELHAMMER DR # 3",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314551",
            "telephone_number": "360-388-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 STEELHAMMER DR # 3",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314551",
            "telephone_number": "360-388-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCHT",
        "first_name": "VICKI",
        "middle_name": "LEE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00034331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.