Provider Demographics
NPI:1720626443
Name:ZINKE, ALEXANDRA STAUNTON (QMHA)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:STAUNTON
Last Name:ZINKE
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:
Other - First Name:ZONDIE
Other - Middle Name:
Other - Last Name:ZINKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:930 W 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-5315
Mailing Address - Country:US
Mailing Address - Phone:650-743-8588
Mailing Address - Fax:
Practice Address - Street 1:1790 W 11TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3871
Practice Address - Country:US
Practice Address - Phone:541-686-2688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor