Provider Demographics
NPI:1124337969
Name:ZACHARA, AMY O (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:O
Last Name:ZACHARA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22722 29TH DR SE STE 100
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-4420
Mailing Address - Country:US
Mailing Address - Phone:425-877-0683
Mailing Address - Fax:425-790-0901
Practice Address - Street 1:10200 NE 132ND ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-2831
Practice Address - Country:US
Practice Address - Phone:425-821-2000
Practice Address - Fax:425-284-1727
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2024-02-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAAP60184986363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health