Healthcare Provider Details

I. General information

NPI: 1831977032
Provider Name (Legal Business Name): MEGAN ZUKOWSKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 SW 116TH ST
SEATTLE WA
98146-2257
US

IV. Provider business mailing address

6719A CARLETON AVE S
SEATTLE WA
98108-3534
US

V. Phone/Fax

Practice location:
  • Phone: 206-631-6229
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60589146
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: