Collista Jean Zook, RN

Individual provider Active NPI Registered Nurse · La Center, WA

NPI 1669904025 · NPPES record last updated Apr 3, 2017

Key facts

NPI
1669904025
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN 60065661 (WA)
Practice address
40101 NE 32ND Ave
La Center, WA 98629-5120
Phone
(360) 335-4928
NPI assigned
Apr 3, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN 60065661WAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 60065661 WA Yes

Addresses

Primary practice location

40101 NE 32ND Ave
La Center, WA 98629-5120

Mailing address

PO Box 410
La Center, WA 98629-0410
Phone (360) 335-4928

Other providers in La Center, WA

All providers in La Center, WA · Registered Nurse in Washington

Sources for this page

Verify at the official NPI Registry.