Provider Demographics
NPI:1821005653
Name:ZACCARI, LAURA K (PA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:K
Last Name:ZACCARI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1535 116TH AVE NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3812
Mailing Address - Country:US
Mailing Address - Phone:425-455-0244
Mailing Address - Fax:425-455-9411
Practice Address - Street 1:1535 116TH AVE NE
Practice Address - Street 2:SUITE 100
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3812
Practice Address - Country:US
Practice Address - Phone:425-455-0244
Practice Address - Fax:425-455-9411
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPA10004019363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant