Healthcare Provider Details

I. General information

NPI: 1447756200
Provider Name (Legal Business Name): ZAKKARY J WALTERSCHEID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 TALBOT RD S STE 300
RENTON WA
98055-5791
US

IV. Provider business mailing address

4011 TALBOT RD S STE 300
RENTON WA
98055-5791
US

V. Phone/Fax

Practice location:
  • Phone: 425-656-5060
  • Fax: 425-656-5047
Mailing address:
  • Phone: 425-656-5060
  • Fax: 425-656-5047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberMD61584176
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD61584176
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: