Healthcare Provider Details

I. General information

NPI: 1154592350
Provider Name (Legal Business Name): JOSEPH A ZUCHERO NA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2008
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 E HAWTHORNE AVE
COLVILLE WA
99114-2629
US

IV. Provider business mailing address

165 E HAWTHORNE AVE
COLVILLE WA
99114-2629
US

V. Phone/Fax

Practice location:
  • Phone: 509-684-4597
  • Fax:
Mailing address:
  • Phone: 509-684-4597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberNC10046652
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: