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General NPI Number Information
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NPI Number | 1861547739
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Entity Type | Individual
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Provider Name | ZACHARY JENKINS PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3431 NW LOWELL ST
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City | SILVERDALE
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State | WA
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Zip | 98383-9120
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Country | US
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Telephone | 360-698-2828
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Fax | 360-697-7965
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Provider Business Mailing Address
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Address Line | PO BOX 2787
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City | POULSBO
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State | WA
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Zip | 98370-2787
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Country | US
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Telephone | 360-698-2828
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Fax | 306-697-7965
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1193
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License Number State | WA
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