Healthcare Provider Details

I. General information

NPI: 1912919085
Provider Name (Legal Business Name): BRONWEN F ZAVALA RN BC MSN CMSRN PCCN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRONWEN FRANCES HOPPE RN

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N WASHINGTON AVE
ARLINGTON WA
98223-1417
US

IV. Provider business mailing address

108 N WASHINGTON AVE
ARLINGTON WA
98223-1417
US

V. Phone/Fax

Practice location:
  • Phone: 425-308-8763
  • Fax:
Mailing address:
  • Phone: 425-308-8763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00104620
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: