Provider Demographics
NPI:1245706811
Name:KOTLERMAN, ZACHARY AARON (DC)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:AARON
Last Name:KOTLERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 GREENLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-2017
Mailing Address - Country:US
Mailing Address - Phone:310-663-5265
Mailing Address - Fax:
Practice Address - Street 1:1100 GREENLEAF AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-2017
Practice Address - Country:US
Practice Address - Phone:310-663-5265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60894940111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty