Provider Demographics
NPI:1013634088
Name:ZEBALA, JOHN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:ZEBALA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 ISSAQUAH PINE LAKE RD SE # 392
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98075-7253
Mailing Address - Country:US
Mailing Address - Phone:425-466-5178
Mailing Address - Fax:
Practice Address - Street 1:215 CLAY ST NW STE B5
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-4213
Practice Address - Country:US
Practice Address - Phone:253-833-8009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00033981207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology