Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP30005761 | WA |
NPI | 1013067644 |
---|---|
Provider Name | David Zane |
First Address | Shoreline, WA 98155-7130 |
Second Address | Shoreline, WA 98155-7130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 24/09/2010 |