Healthcare Provider Details

I. General information

NPI: 1659288348
Provider Name (Legal Business Name): LUKE ZENZIC-QUINLAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

837 CALLAHAN DR
BREMERTON WA
98310-3368
US

IV. Provider business mailing address

9448 HOLLY FARM LN NE
BAINBRIDGE ISLAND WA
98110-1637
US

V. Phone/Fax

Practice location:
  • Phone: 360-240-0022
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: