MEDICARE: MR. DANIEL JOSEPH ZIZZA L.AC.

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	171100000X	Acupuncturist	00000055	WA

General Provider Information

NPI Number	:	1386861037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL JOSEPH ZIZZA L.AC.

Provider Business Mailing Address
First Line	:	613 19TH AVE E STE 202
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98112-4000
Country	:	US
Telephone Number	:	206-329-5466
Fax Number	:	206-720-6286

Provider Business Practice Location Address
First Line	:	613 19TH AVE E STE 202
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98112-4000
Country	:	US
Telephone Number	:	206-329-5466
Fax Number	:	206-720-6286

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	07/08/2007

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