Healthcare Provider Details

I. General information

NPI: 1811011356
Provider Name (Legal Business Name): DAVID ZEOLI ND, LAC, DOM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 11/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 SW 16TH ST SUITE 126
RENTON WA
98057-2697
US

IV. Provider business mailing address

801 SW 16TH ST SUITE 126
RENTON WA
98057-2697
US

V. Phone/Fax

Practice location:
  • Phone: 425-271-8689
  • Fax:
Mailing address:
  • Phone: 425-271-8689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number916
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT00000924
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00000602
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: