Healthcare Provider Details

I. General information

NPI: 1811140353
Provider Name (Legal Business Name): BILHA V ZOMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 04/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EAST MAIN ST. SUITE 100
AUBURN WA
98002
US

IV. Provider business mailing address

PO BOX 34876
SEATTLE WA
98124-1876
US

V. Phone/Fax

Practice location:
  • Phone: 253-939-9654
  • Fax: 253-939-6549
Mailing address:
  • Phone: 425-656-5412
  • Fax: 425-656-4096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD060041782
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: