Healthcare Provider Details

I. General information

NPI: 1033879002
Provider Name (Legal Business Name): LILIAN ZAPATA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ELIOT ZAPATA

II. Dates (important events)

Enumeration Date: 12/17/2021
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE # 359702
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

325 9TH AVE # 359702
SEATTLE WA
98104-2420
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-2556
  • Fax:
Mailing address:
  • Phone: 206-744-2556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMDRE.ML.61543997
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: