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General NPI Number Information
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NPI Number | 1275049744
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Entity Type | Individual
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Provider Name | AMBER NICOLE ZOOT CNA
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Gender | Female
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Dates
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Enumeration Date | 12/20/2017
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Last Update Date | 12/20/2017
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Provider Practice Location Address
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Address Line | 2305 NE 129TH ST
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City | VANCOUVER
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State | WA
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Zip | 98686-3212
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Country | US
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Telephone | 360-200-0776
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Fax |
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Provider Business Mailing Address
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Address Line | 206 NE 126TH AVE APT E59
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City | VANCOUVER
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State | WA
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Zip | 98684-1809
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Country | US
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Telephone | 360-852-0345
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Fax |
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 60603906
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License Number State | WA
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