Provider Demographics
NPI:1215415336
Name:ZUBIENA, JACLYN A
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:A
Last Name:ZUBIENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 88TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:WA
Mailing Address - Zip Code:98039-4831
Mailing Address - Country:US
Mailing Address - Phone:888-291-7245
Mailing Address - Fax:
Practice Address - Street 1:924 88TH AVE NE
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:WA
Practice Address - Zip Code:98039-4831
Practice Address - Country:US
Practice Address - Phone:888-291-7245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator