Healthcare Provider Details

I. General information

NPI: 1497991053
Provider Name (Legal Business Name): JEAN MARIE ZAHALKA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2008
Last Update Date: 02/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 RUCKER AVE SUITE 300
EVERETT WA
98201-3900
US

IV. Provider business mailing address

5629 220TH ST NW
STANWOOD WA
98292-6807
US

V. Phone/Fax

Practice location:
  • Phone: 425-339-8717
  • Fax: 425-339-8706
Mailing address:
  • Phone: 360-654-1350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN00051798
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: