Healthcare Provider Details

I. General information

NPI: 1659258747
Provider Name (Legal Business Name): MS. ERICA ZINK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 ELOCHOMAN VALLEY RD BLDG 1
CATHLAMET WA
98612-9602
US

IV. Provider business mailing address

42 ELOCHOMAN VALLEY RD BLDG 1
CATHLAMET WA
98612-9602
US

V. Phone/Fax

Practice location:
  • Phone: 360-795-8630
  • Fax:
Mailing address:
  • Phone: 360-795-8630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: