Provider Demographics
NPI:1477674109
Name:ZEILER, SAMUEL CONRAD (RC CN)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:CONRAD
Last Name:ZEILER
Suffix:
Gender:M
Credentials:RC CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10716 PALATINE AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8727
Mailing Address - Country:US
Mailing Address - Phone:206-365-1030
Mailing Address - Fax:206-365-9104
Practice Address - Street 1:5029 ROOSEVELT WAY NE STE 101A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3697
Practice Address - Country:US
Practice Address - Phone:206-365-1030
Practice Address - Fax:206-365-9104
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00024869174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist