Healthcare Provider Details

I. General information

NPI: 1003363334
Provider Name (Legal Business Name): ZAIDIA SENIOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2016
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3145 ALAMEDA ST UNIT 19
MEDFORD OR
97504-8643
US

IV. Provider business mailing address

3145 ALAMEDA ST UNIT 19
MEDFORD OR
97504-8643
US

V. Phone/Fax

Practice location:
  • Phone: 954-609-6361
  • Fax:
Mailing address:
  • Phone: 954-609-6361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: