MEDICARE: DONALD P. ZIETZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist

General Provider Information

NPI Number	:	1053749564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONALD P. ZIETZ

Provider Business Mailing Address
First Line	:	1810 E COLLEGE WAY
Second Line	:	SUITE 110
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-2362
Country	:	US
Telephone Number	:	360-336-5881
Fax Number	:	360-336-2323

Provider Business Practice Location Address
First Line	:	1810 E COLLEGE WAY
Second Line	:	SUITE 110
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-2362
Country	:	US
Telephone Number	:	360-336-5881
Fax Number	:	360-336-2323

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DONALD P. ZIETZ
Credential	:	AAS-HIS
Telephone Number	:	360-336-5881

Provider Enumeration Date	:	10/18/2013
Last Update Date	:	10/18/2013

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Directions to “DONALD P. ZIETZ ” Practice Location

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