Provider Demographics
NPI:1922178961
Name:ZINN VENTURES, INC.
Entity Type:Organization
Organization Name:ZINN VENTURES, INC.
Other - Org Name:WADE ZINN PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WADE
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:ZINN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:360-697-7710
Mailing Address - Street 1:24806 PORT GAMBLE RD NE
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8826
Mailing Address - Country:US
Mailing Address - Phone:360-297-8059
Mailing Address - Fax:
Practice Address - Street 1:19611 7TH AVE NE
Practice Address - Street 2:SUITE 200
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7384
Practice Address - Country:US
Practice Address - Phone:360-697-7710
Practice Address - Fax:360-779-3829
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ZINN VENTURES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-08
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005860225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8346520Medicaid
WA7074917Medicaid
WA7074917Medicaid