MEDICARE: ZACHARY CARVALHO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1881428399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY CARVALHO

Provider Business Mailing Address
First Line	:	716 STEVENS AVE
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-2693
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1819 23RD AVE APT E316
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-3096
Country	:	US
Telephone Number	:	808-366-2287
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2024
Last Update Date	:	08/27/2024

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Directions to “ ZACHARY CARVALHO ” Practice Location

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