Pacific Northwest Neurology PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD00027139 Issued in WA

Legal business name

PACIFIC NORTHWEST NEUROLOGY PLLC

Practice address

215 Wilkes St
Ste 202
Steilacoom, WA 98388-2125

Phone

(253) 581-8151

Fax

(253) 581-8152

NPI assigned

Feb 11, 2008

Last updated

Jun 26, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Gregory Zoltani, M.D.NPI 1497766224

Title

Owner

Phone

(253) 581-8151

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Gregory Zoltani, MD

  • Neurology Physician
  • Lakewood, WA
  • NPI 1497766224
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1194993311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 WILKES ST",
            "address_2": "STE 202",
            "city": "STEILACOOM",
            "state": "WA",
            "postal_code": "983882125",
            "telephone_number": "253-581-8151",
            "fax_number": "253-581-8152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 WILKES ST",
            "address_2": "STE 202",
            "city": "STEILACOOM",
            "state": "WA",
            "postal_code": "983882125",
            "telephone_number": "253-581-8151",
            "fax_number": "253-581-8152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NORTHWEST NEUROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "ZOLTANI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-581-8151",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00027139",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00024442",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR & INDUSTRIES",
            "identifier": "0062048",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1056415",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Ann McGowan, FNP
• Michael McDade, D.D.S.,P.L.L.C.
• Timothy Reid Miller, DDS
• Joseph Michael Mitrovich, PSY.D.
• Sheryl Lynn Morelli, LMP
• Iona May Parker, APRN-BC
• Roxanne S Peterson
• Jordan Patrick Sanders, LMHC; LPC-MHSP
• Sea Spa Steilacoom
• Sea Spa Steilacoom

• Specialist in Steilacoom, WA
• Providers in Steilacoom, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.