Healthcare Provider Details

I. General information

NPI: 1811763386
Provider Name (Legal Business Name): JENNIFER ZHOU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 MELROSE AVE
SEATTLE WA
98122-3608
US

IV. Provider business mailing address

1530 MELROSE AVE
SEATTLE WA
98122-3608
US

V. Phone/Fax

Practice location:
  • Phone: 206-586-8442
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDENT.DE.70140246
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: