Healthcare Provider Details

I. General information

NPI: 1023773637
Provider Name (Legal Business Name): CARLA VALERIA ZAPATA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 11/08/2021
Certification Date: 11/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8720 14TH AVE S
SEATTLE WA
98108-4807
US

IV. Provider business mailing address

8801 14TH AVE S
SEATTLE WA
98108-4809
US

V. Phone/Fax

Practice location:
  • Phone: 206-762-3730
  • Fax:
Mailing address:
  • Phone: 206-766-6976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: