Healthcare Provider Details

I. General information

NPI: 1477635159
Provider Name (Legal Business Name): STEVEN R ZIRKER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 10/20/2024
Certification Date: 10/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 DALE AVE
BENTON CITY WA
99320-5250
US

IV. Provider business mailing address

723 MEMORIAL ST
PROSSER WA
99350-1524
US

V. Phone/Fax

Practice location:
  • Phone: 509-588-4075
  • Fax: 509-588-4197
Mailing address:
  • Phone: 509-786-2222
  • Fax: 509-786-6612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA10003881
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: