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General NPI Number Information
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NPI Number | 1154447217
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Entity Type | Organization
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Legal Business Name | GERARD ZANOLLI MD PLLC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 09/21/2011
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Provider Practice Location Address
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Address Line | 5236 CALIFORNIA AVE SW SUITE B
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City | SEATTLE
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State | WA
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Zip | 98136-1244
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Country | US
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Telephone | 206-938-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 5236 CALIFORNIA AVE SW SUITE B
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City | SEATTLE
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State | WA
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Zip | 98136-1244
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Country | US
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Telephone | 206-938-4200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GERARD M. ZANOLLI
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Credential | M.D.
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Telephone | 206-938-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD00034812
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD00034812
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License Number State | WA
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