Healthcare Provider Details

I. General information

NPI: 1598019234
Provider Name (Legal Business Name): CAROLINE J ZAWORSKI ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2012
Last Update Date: 12/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 NW PROFESSIONAL DR STE 100
CORVALLIS OR
97330-3891
US

IV. Provider business mailing address

2211 NW PROFESSIONAL DR STE 100
CORVALLIS OR
97330-3891
US

V. Phone/Fax

Practice location:
  • Phone: 541-812-4661
  • Fax: 541-812-4660
Mailing address:
  • Phone: 844-374-4254
  • Fax: 541-230-1189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number201250181NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: