MEDICARE: JORGE ZENDEJAS FLORES

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	183500000X	Pharmacist	60789665	WA

General Provider Information

NPI Number	:	1518536648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORGE ZENDEJAS FLORES

Provider Business Mailing Address
First Line	:	12811 BEVERLY PARK RD
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98087-5126
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12811 BEVERLY PARK RD
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98087-5126
Country	:	US
Telephone Number	:	425-347-3145
Fax Number	:

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

Provider Enumeration Date	:	06/22/2021
Last Update Date	:	06/22/2021

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