Provider Demographics
NPI:1336910660
Name:ZIMOWSKI, TASHA JANELLE (RN MSN CCM)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:JANELLE
Last Name:ZIMOWSKI
Suffix:
Gender:F
Credentials:RN MSN CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:FIRCREST
Mailing Address - State:WA
Mailing Address - Zip Code:98466-6681
Mailing Address - Country:US
Mailing Address - Phone:310-259-1580
Mailing Address - Fax:
Practice Address - Street 1:301 BIRCH ST
Practice Address - Street 2:
Practice Address - City:FIRCREST
Practice Address - State:WA
Practice Address - Zip Code:98466-6681
Practice Address - Country:US
Practice Address - Phone:310-259-1580
Practice Address - Fax:877-211-6860
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61470630163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management