Healthcare Provider Details

I. General information

NPI: 1871436139
Provider Name (Legal Business Name): COLLETTE ALISHA ZACARIAS APRN-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COLLETTE ALISHA DUFOUR

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 JASON ST NE STE 100
SALEM OR
97301-2357
US

IV. Provider business mailing address

631 JASON ST NE STE 100
SALEM OR
97301-2357
US

V. Phone/Fax

Practice location:
  • Phone: 971-273-0084
  • Fax:
Mailing address:
  • Phone: 971-273-0084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10067465
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number202009648RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: