Provider Demographics
NPI:1770971624
Name:OHNEMUS, ZACHARY
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:OHNEMUS
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 1:402 S 333RD ST
Mailing Address - Street 2:SUITE 121
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6309
Mailing Address - Country:US
Mailing Address - Phone:949-292-4264
Mailing Address - Fax:
Practice Address - Street 1:402 S 333RD ST
Practice Address - Street 2:SUITE 121
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6309
Practice Address - Country:US
Practice Address - Phone:949-292-4264
Practice Address - Fax:866-311-9279
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60493505101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health