Provider Demographics
NPI:1831500388
Name:ZARATE-ROURKE, NEHEMIAH
Entity type:Individual
Prefix:
First Name:NEHEMIAH
Middle Name:
Last Name:ZARATE-ROURKE
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 1:1721 HEWITT AVE STE 506
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3546
Mailing Address - Country:US
Mailing Address - Phone:425-407-2771
Mailing Address - Fax:425-484-1384
Practice Address - Street 1:1721 HEWITT AVE STE 506
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3546
Practice Address - Country:US
Practice Address - Phone:425-407-2771
Practice Address - Fax:425-484-1384
Is Sole Proprietor?:No
Enumeration Date:2014-05-17
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60200258163W00000X, 163WP0808X
WAAP61074114363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health