Provider Demographics
NPI:1831843051
Name:MABALAY, ZACHARY (DC)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:MABALAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:ZACHARY
Other - Middle Name:
Other - Last Name:STATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:402 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3113
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:402 W 8TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3113
Practice Address - Country:US
Practice Address - Phone:360-828-5049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61257564111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor