Provider Demographics
NPI:1134246234
Name:ZONGAS, DANA L (OTR)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:ZONGAS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5808A SUMMITVIEW AVE
Mailing Address - Street 2:#48
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-2764
Mailing Address - Country:US
Mailing Address - Phone:509-307-6619
Mailing Address - Fax:509-494-7011
Practice Address - Street 1:6109 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-2764
Practice Address - Country:US
Practice Address - Phone:509-307-6619
Practice Address - Fax:509-494-7011
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001358225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7683212Medicaid