Physician Compare National (NPI:1104394824)

HEALTHCARE PROVIDER: LYDIA ALICE ZAJACKOWSKI D.C.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1104394824
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7911337035
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200413003283
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ZAJACKOWSKI
	Individual professional last name
Provider First Name	LYDIA
	Individual professional first name
Provider Middle Name	ALICE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LIFE CHIROPRACTIC COLLEGE - WEST
	Individual professional's medical school
Graduation Year	2018
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1500 ALPENSEE STRASSE
	Group Practice or individual's line 1 address
City	LEAVENWORTH
	Group Practice or individual's city
State	WA
	Group Practice or individual's state
Zip Code	988269308
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y