Healthcare Provider Details

I. General information

NPI: 1386861037
Provider Name (Legal Business Name): DANIEL JOSEPH ZIZZA L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 19TH AVE E STE 202
SEATTLE WA
98112-4000
US

IV. Provider business mailing address

613 19TH AVE E STE 202
SEATTLE WA
98112-4000
US

V. Phone/Fax

Practice location:
  • Phone: 206-329-5466
  • Fax: 206-720-6286
Mailing address:
  • Phone: 206-329-5466
  • Fax: 206-720-6286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number00000055
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: