Healthcare Provider Details

I. General information

NPI: 1457807174
Provider Name (Legal Business Name): NATHAN ZIEGMAN PARAMEDIC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4259 23RD AVENUE WEST
SEATTLE WA
98199
US

IV. Provider business mailing address

816 TOPEKA LANE
VANCOUVER WA
98664
US

V. Phone/Fax

Practice location:
  • Phone: 206-631-2822
  • Fax:
Mailing address:
  • Phone: 360-910-4576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number0172647
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number3201016056
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number133013
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number134054
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: