Provider Demographics
NPI:1275736373
Name:ZAPP-GARCIA, JACQUELINE ALEXANDRA (CPM, LDM)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:ALEXANDRA
Last Name:ZAPP-GARCIA
Suffix:
Gender:F
Credentials:CPM, LDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5414 N MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-4568
Mailing Address - Country:US
Mailing Address - Phone:971-570-0688
Mailing Address - Fax:503-247-8053
Practice Address - Street 1:5414 N MONTANA AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-4568
Practice Address - Country:US
Practice Address - Phone:971-570-0688
Practice Address - Fax:503-247-8053
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDEM-LD-10117448175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay