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General NPI Number Information
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NPI Number | 1477305365
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Entity Type | Individual
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Provider Name | MICA ZIMMERMAN BSN, RN, DNP, CNM
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Gender | Female
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Dates
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Enumeration Date | 04/03/2024
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 700 NE 87TH AVE STE AND170
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City | VANCOUVER
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State | WA
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Zip | 98664-4896
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Country | US
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Telephone | 360-882-2778
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Fax |
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Provider Business Mailing Address
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Address Line | 5014 SE TOLMAN ST
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City | PORTLAND
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State | OR
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Zip | 97206-6974
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Country | US
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Telephone | 925-212-1182
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | AP61565827
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN61267058
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 202111495RN
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License Number State | OR
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