Provider Demographics
NPI:1679592364
Name:ZIEMANN, JOY LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOY
Middle Name:LOUISE
Last Name:ZIEMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34616 11TH PL S
Mailing Address - Street 2:STE 4
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8705
Mailing Address - Country:US
Mailing Address - Phone:253-927-9460
Mailing Address - Fax:253-927-2168
Practice Address - Street 1:34616 11TH PL S
Practice Address - Street 2:STE 4
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8705
Practice Address - Country:US
Practice Address - Phone:253-927-9460
Practice Address - Fax:253-927-2168
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA015666207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1490804Medicaid
WA42503OtherL & I
WA1490804Medicaid
WA910997927OtherTIN
WA0106008Medicare ID - Type Unspecified