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NPI Code Detail

MEDICARE: DERYK MARK ZINSER DO

MEDICARE: DERYK MARK ZINSER DO
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
1207Q00000XFamily Medicine PhysicianDO156518OR

General Provider Information

NPI Number : 1336371517
Entity Type Code : Individual
Provider Name (Legal Business Name) : DERYK MARK ZINSER DO
Provider Business Mailing Address
First Line : 36860 INDUSTRIAL WAY
Second Line :
City : SANDY
State : OR
Zip : 97055-7371
Country : US
Telephone Number : 503-826-0206
Fax Number : 503-826-0216
Provider Business Practice Location Address
First Line : 36860 INDUSTRIAL WAY
Second Line :
City : SANDY
State : OR
Zip : 97055-7371
Country : US
Telephone Number : 503-826-0206
Fax Number : 503-826-0216
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2009
Last Update Date : 10/04/2013

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Directions to “ DERYK MARK ZINSER DO” Practice Location

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