Provider Demographics
NPI:1003925785
Name:ZOLLMAN, TED M (MD)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:M
Last Name:ZOLLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1101 MADISON ST
Mailing Address - Street 2:STE. 600
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1306
Mailing Address - Country:US
Mailing Address - Phone:206-215-2020
Mailing Address - Fax:206-215-2022
Practice Address - Street 1:1101 MADISON ST
Practice Address - Street 2:STE. 600
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1306
Practice Address - Country:US
Practice Address - Phone:206-215-2020
Practice Address - Fax:206-215-2022
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00037264207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0129181OtherL&I
WA8240814Medicaid
WA8240814Medicaid