Provider Demographics
NPI:1063426146
Name:WEBB, ZACHARY ALAN (MD)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:ALAN
Last Name:WEBB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 KING ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-6223
Mailing Address - Country:US
Mailing Address - Phone:360-676-1696
Mailing Address - Fax:360-676-6636
Practice Address - Street 1:1345 KING ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-6223
Practice Address - Country:US
Practice Address - Phone:360-676-1696
Practice Address - Fax:360-676-6636
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000451892084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5111WEOtherREGENCE
WA8429920Medicaid
WAI14669Medicare UPIN
WAG8854945Medicare ID - Type Unspecified