Provider Demographics
NPI:1497807663
Name:ZEITNER, MARY ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELIZABETH
Last Name:ZEITNER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:956 MAPLE WAY
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-3332
Mailing Address - Country:US
Mailing Address - Phone:425-640-2994
Mailing Address - Fax:707-248-0722
Practice Address - Street 1:21601 76TH AVENUE WEST
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-9905
Practice Address - Country:US
Practice Address - Phone:425-640-4090
Practice Address - Fax:425-640-4446
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPA10004675363AM0700X
OH50-00-1199363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical