Provider Demographics
NPI:1073276507
Name:NZIMANDE, ZOE (RDN)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:
Last Name:NZIMANDE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2641 42ND AVE SW APT 412
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4607
Mailing Address - Country:US
Mailing Address - Phone:609-851-3293
Mailing Address - Fax:
Practice Address - Street 1:2641 42ND AVE SW APT 412
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4607
Practice Address - Country:US
Practice Address - Phone:609-851-3293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI61234936133V00000X
CA86099495133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2202828Medicaid