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NPI Code Detail

MEDICARE: COLLETE BELLE ZACK

MEDICARE:   COLLETE BELLE ZACK
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
1225700000XMassage Therapist28253OR

General Provider Information

NPI Number : 1407698228
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLETE BELLE ZACK
Provider Business Mailing Address
First Line : 1510 TAYLOR AVE
Second Line :
City : HOOD RIVER
State : OR
Zip : 97031-1559
Country : US
Telephone Number : 541-490-6634
Fax Number :
Provider Business Practice Location Address
First Line : 1109 HULL ST
Second Line :
City : HOOD RIVER
State : OR
Zip : 97031-1944
Country : US
Telephone Number : 541-490-6634
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2024
Last Update Date : 06/11/2024

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Directions to “ COLLETE BELLE ZACK ” Practice Location

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