Provider Demographics
NPI:1003399197
Name:ZINIEWICZ, CRYSTAL ANNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:ANNE
Last Name:ZINIEWICZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12223 MOUNTAIN CRUISER LN NW APT B304
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8021
Mailing Address - Country:US
Mailing Address - Phone:413-575-2427
Mailing Address - Fax:
Practice Address - Street 1:1121 124TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2101
Practice Address - Country:US
Practice Address - Phone:413-575-2427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60867973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist