Healthcare Provider Details

I. General information

NPI: 1053787911
Provider Name (Legal Business Name): ELENA V ZINKOV N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 08/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 E GREEN LAKE WAY N APT 417
SEATTLE WA
98115-8618
US

IV. Provider business mailing address

6900 E GREEN LAKE WAY N APT 417
SEATTLE WA
98115-8618
US

V. Phone/Fax

Practice location:
  • Phone: 425-802-1914
  • Fax:
Mailing address:
  • Phone: 425-802-1914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: