Healthcare Provider Details

I. General information

NPI: 1689408965
Provider Name (Legal Business Name): ZACHARY JAMES MINION DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 E NOB HILL BLVD
YAKIMA WA
98901-3534
US

IV. Provider business mailing address

PO BOX 190
TOPPENISH WA
98948-0190
US

V. Phone/Fax

Practice location:
  • Phone: 509-248-1082
  • Fax:
Mailing address:
  • Phone: 509-408-6298
  • Fax: 509-865-0757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDENT.DE.61680187
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number61570818
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: