Doctor Name: | MARY-COLLEEN D. ZUCCONI |
NPI Number: | 1194969717 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A. |
License Number: | |
Business Practice Address: | 200 Ne Mother Joseph Pl Suite 210 Vancouver, WA - 986643299 |
Business Phone Number: | 3604491144 |
Business Fax Number: | 3608235617 |
Mailing Address: | 200 Ne Mother Joseph Pl, Ste 210 VANCOUVER |
State: | WA |
Postal Code: | 986643295 |
Phone Number: | 5038308149 |
Fax Number: | |
NPI Enumeration Date: | 04/27/2009 |
NPI Last Update Date: | 02/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |