Provider Demographics
NPI:1326181447
Name:ZOZAYA, ROBERT (LMT LMP)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:ZOZAYA
Suffix:
Gender:M
Credentials:LMT LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14401 NE 31ST ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-8183
Mailing Address - Country:US
Mailing Address - Phone:360-904-7858
Mailing Address - Fax:
Practice Address - Street 1:7902 NE ST JOHNS RD STE 107B
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-1094
Practice Address - Country:US
Practice Address - Phone:360-904-7858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00020384174400000X
OR11816174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist