Provider Demographics
NPI:1881867679
Name:BACH-ZEEROCAH, ELKE (MSW)
Entity Type:Individual
Prefix:
First Name:ELKE
Middle Name:
Last Name:BACH-ZEEROCAH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ELKE
Other - Middle Name:FALEAFINE
Other - Last Name:BACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:9040 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1101
Mailing Address - Country:US
Mailing Address - Phone:253-968-4851
Mailing Address - Fax:253-968-3731
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1101
Practice Address - Country:US
Practice Address - Phone:253-968-4851
Practice Address - Fax:253-968-3731
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000065391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical