Active NPI
Darice L Zabak, MD
- Family Medicine Physician
- Tigard, OR
National Provider Identifier
1275510950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036109954
- Practice address
- 9250 SW Hall Blvd
Tigard, OR 97223-6721 - Phone
- (503) 293-0161
- NPI assigned
- Dec 23, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036109954 | IL | Primary |
Addresses
Primary practice location
9250 SW Hall Blvd
Tigard, OR 97223-6721
Mailing address
9250 SW Hall Blvd
Tigard, OR 97223-6721
Phone (503) 293-0161
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036109954 | Other | IL | STATE LICENSE |
| 036109954 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036109954 | IL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399939200000",
"number": "1275510950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9250 SW HALL BLVD",
"city": "TIGARD",
"state": "OR",
"postal_code": "972236721",
"telephone_number": "503-293-0161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9250 SW HALL BLVD",
"city": "TIGARD",
"state": "OR",
"postal_code": "972236721",
"telephone_number": "503-293-0161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZABAK",
"first_name": "DARICE",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-23",
"last_updated": "2014-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036109954",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "036109954",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036109954",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.