Healthcare Provider Details

I. General information

NPI: 1215266747
Provider Name (Legal Business Name): KATE ZEBATTO VICTOR PA-C, MMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATE BRIELLE ZEBATTO

II. Dates (important events)

Enumeration Date: 12/11/2009
Last Update Date: 08/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 NE 87TH AVE
VANCOUVER WA
98664
US

IV. Provider business mailing address

PO BOX 873010
VANCOUVER WA
98687-3010
US

V. Phone/Fax

Practice location:
  • Phone: 360-882-2778
  • Fax: 360-604-1697
Mailing address:
  • Phone: 360-882-2778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA60694683
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number002998
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: