Provider Demographics
NPI:1932139581
Name:ZIMMER, HAROLD L (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:L
Last Name:ZIMMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1200 112TH AVE NE
Mailing Address - Street 2:C115
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3732
Mailing Address - Country:US
Mailing Address - Phone:425-455-0244
Mailing Address - Fax:425-455-9411
Practice Address - Street 1:1200 112TH AVE NE
Practice Address - Street 2:C115
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:2006-07-03
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA18175207V00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA000106011Medicaid
WA000106011Medicaid