Provider Demographics
NPI:1003080060
Name:ZENGER, MARY ANN (LMP)
Entity Type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:ZENGER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2929
Mailing Address - Country:US
Mailing Address - Phone:360-563-0201
Mailing Address - Fax:
Practice Address - Street 1:1519 132ND ST SE
Practice Address - Street 2:SUITE A
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-7203
Practice Address - Country:US
Practice Address - Phone:425-337-9556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-21
Last Update Date:2008-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00004732225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5305ZEOtherREGENCE
WA8947201OtherL&I CRIME
WA0235088OtherDEPT OF L&I
WA237869OtherL&I
WA7568ZEOtherREGENCE
WA8948048OtherL&I CRIME VICTIMS