Provider Demographics
NPI:1568547263
Name:ZIMBUREAN, JOHN M (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:ZIMBUREAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15418 MAIN ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-9030
Mailing Address - Country:US
Mailing Address - Phone:425-385-2960
Mailing Address - Fax:425-357-0924
Practice Address - Street 1:15418 MAIN ST
Practice Address - Street 2:SUITE 301
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-9030
Practice Address - Country:US
Practice Address - Phone:425-385-2960
Practice Address - Fax:425-357-0924
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2008-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD000334192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB16993Medicare PIN