Healthcare Provider Details
I. General information
NPI: 1073033965
Provider Name (Legal Business Name): ELIZABETH CLAIRE ZAROFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/22/2017
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3100 NW BUCKLIN HILL RD STE 202
SILVERDALE WA
98383-8362
US
IV. Provider business mailing address
955 POWELL AVE SW
RENTON WA
98057-2908
US
V. Phone/Fax
- Phone: 360-377-3776
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | AP60776853 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | AP60776853 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: