Provider Demographics
NPI:1023525342
Name:KEATING-ZORN, GREGORY JOHN (DNP)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:JOHN
Last Name:KEATING-ZORN
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17340 1ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-3636
Mailing Address - Country:US
Mailing Address - Phone:585-754-5011
Mailing Address - Fax:
Practice Address - Street 1:10333 19TH AVE SE STE 109
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-4267
Practice Address - Country:US
Practice Address - Phone:425-742-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61645168363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health