Provider Demographics
NPI:1316215593
Name:ZUGSCHWERDT, ZACHARY NOLAN (DC, CCSP)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:NOLAN
Last Name:ZUGSCHWERDT
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 5TH AVE N
Mailing Address - Street 2:STE A
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-5316
Mailing Address - Country:US
Mailing Address - Phone:206-858-6667
Mailing Address - Fax:206-607-9957
Practice Address - Street 1:621 5TH AVE N STE A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4241
Practice Address - Country:US
Practice Address - Phone:206-858-6667
Practice Address - Fax:206-607-9957
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32019111NS0005X
WACH 60271312111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician