Victory Athletic Exchange

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

VICTORY ATHLETIC EXCHANGE

Practice address

3915 H St Apt D
Vancouver, WA 98663-1880

Phone

(360) 409-1031

NPI assigned

Oct 16, 2024

Organization subpart

No

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

Authorized official

Name

Austin Jacob Candanoza

Title

Executive Director

Phone

(424) 383-4905

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1679393250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 H ST APT D",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986631880",
            "telephone_number": "360-409-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 H ST APT D",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986631880",
            "telephone_number": "360-409-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY ATHLETIC EXCHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "CANDANOZA",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "424-383-4905"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Michelle Vickers, LMHC
• Ken Vickery, LCSW
• Kate Zebatto Victor, PA-C, MMS
• Victoria Paulus, LLC
• Clarence Gail Victoria, SLP
• Victory Spine and Sport PLLC
• Jimena Vicuna
• Nancy Jo Vieira
• Tatiana Dawn Viera
• Sofia Viewkova

• Case Management Agency in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Case Management Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.