Healthcare Provider Details

I. General information

NPI: 1336873553
Provider Name (Legal Business Name): JOANNA ZARELLI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 08/02/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 S FIFE ST STE 301
TACOMA WA
98409-7309
US

IV. Provider business mailing address

5123 GREEN HILLS AVE NE APT A
TACOMA WA
98422-4540
US

V. Phone/Fax

Practice location:
  • Phone: 253-589-5334
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number60527412
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: