Provider Demographics
NPI:1407929086
Name:ZARNECKI, MATTHEW E (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:E
Last Name:ZARNECKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 NW MYHRE RD
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8676
Mailing Address - Country:US
Mailing Address - Phone:360-698-0404
Mailing Address - Fax:360-698-5265
Practice Address - Street 1:1780 NW MYHRE RD
Practice Address - Street 2:SUITE 1250
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8676
Practice Address - Country:US
Practice Address - Phone:360-698-0404
Practice Address - Fax:360-698-5265
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00021496207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8507352Medicaid
WA1259001Medicaid
WA8507352Medicaid
WA1259001Medicaid
WAG8872986Medicare PIN