Healthcare Provider Details

I. General information

NPI: 1194307553
Provider Name (Legal Business Name): MRS. ALMA ZOTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 04/26/2021
Certification Date: 04/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 91ST AVE NE
LAKE STEVENS WA
98258-2541
US

IV. Provider business mailing address

303 91ST AVE NE
LAKE STEVENS WA
98258-2541
US

V. Phone/Fax

Practice location:
  • Phone: 425-335-4513
  • Fax: 425-334-7814
Mailing address:
  • Phone: 425-335-4513
  • Fax: 425-334-7814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberVA60876809
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: