Provider Demographics
NPI:1598810087
Name:ZIPEROVICH, DANIEL PEDRO (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:PEDRO
Last Name:ZIPEROVICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16233 SYLVESTER RD SW
Mailing Address - Street 2:SUITE 280
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166
Mailing Address - Country:US
Mailing Address - Phone:206-433-2069
Mailing Address - Fax:206-248-7363
Practice Address - Street 1:16233 SYLVESTER RD SW
Practice Address - Street 2:SUITE 280
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166
Practice Address - Country:US
Practice Address - Phone:206-433-2069
Practice Address - Fax:206-248-7363
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025933207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1050459Medicaid
WA1050459Medicaid