MEDICARE: MIRIAM ZEGHMI MSW, LSWAIC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1659949824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRIAM ZEGHMI MSW, LSWAIC

Provider Business Mailing Address
First Line	:	704 228TH AVE NE # 931
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98074-7222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 228TH AVE NE # 931
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98074-7222
Country	:	US
Telephone Number	:	425-428-7517
Fax Number	:

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

Provider Enumeration Date	:	06/15/2021
Last Update Date	:	06/15/2021

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