Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | N361199745 | WA |
NPI | 1023599479 |
---|---|
Provider Name | Celina Zamora |
First Address | Vancouver, WA 98682-1567 |
Second Address | Vancouver, WA 98661-3717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2018 |
Last Update Date | 22/09/2021 |