Provider Demographics
NPI:1912366881
Name:ZAMARRON, TARA L (FNP-C)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:L
Last Name:ZAMARRON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 N CHELAN AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2028
Mailing Address - Country:US
Mailing Address - Phone:509-663-8711
Mailing Address - Fax:509-764-3244
Practice Address - Street 1:1550 S. PIONEER WAY
Practice Address - Street 2:SAMARITAN FAMILY PHYSICIANS
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837
Practice Address - Country:US
Practice Address - Phone:509-793-9780
Practice Address - Fax:509-764-3246
Is Sole Proprietor?:No
Enumeration Date:2016-02-19
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60631211363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2055725Medicaid