Healthcare Provider Details

I. General information

NPI: 1417350141
Provider Name (Legal Business Name): ZACHARY SCOTT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2014
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4025 DELRIDGE WAY SW STE 400
SEATTLE WA
98106-1249
US

IV. Provider business mailing address

8650 20TH AVE SW
SEATTLE WA
98106-2320
US

V. Phone/Fax

Practice location:
  • Phone: 206-763-2626
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number10063421
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: