Healthcare Provider Details

I. General information

NPI: 1831180793
Provider Name (Legal Business Name): JORGE ZAPATA MD.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 10/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9750 LEVIN RD NW
SILVERDALE WA
98383-8399
US

IV. Provider business mailing address

9750 LEVIN RD NW
SILVERDALE WA
98383-8399
US

V. Phone/Fax

Practice location:
  • Phone: 360-307-7202
  • Fax: 360-698-6600
Mailing address:
  • Phone: 360-307-7202
  • Fax: 360-698-6600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD00016403
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: