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General NPI Number Information
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NPI Number | 1245657360
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Entity Type | Individual
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Provider Name | EMILY VONNE ZIMMERMAN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2014
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Last Update Date | 03/26/2014
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Provider Practice Location Address
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Address Line | 621 PACIFIC AVE SUITE 109
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City | TACOMA
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State | WA
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Zip | 98402-4600
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Country | US
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Telephone | 253-269-6063
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Fax | 360-539-5938
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Provider Business Mailing Address
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Address Line | 7201 40TH ST W
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-4308
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Country | US
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Telephone | 253-269-6063
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Fax | 360-539-5938
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY 60267308
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License Number State | WA
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