Provider Demographics
NPI:1720327588
Name:KENEALEY, ZACHARIAH
Entity Type:Individual
Prefix:
First Name:ZACHARIAH
Middle Name:
Last Name:KENEALEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10002 AURORA AVE N
Mailing Address - Street 2:SUITE 30
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9347
Mailing Address - Country:US
Mailing Address - Phone:206-782-1597
Mailing Address - Fax:206-902-4341
Practice Address - Street 1:10002 AURORA AVE N
Practice Address - Street 2:SUITE 30
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9347
Practice Address - Country:US
Practice Address - Phone:206-782-1597
Practice Address - Fax:206-902-4341
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-13
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHA60270051237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist