Provider Demographics
NPI:1194104943
Name:ZALE PROFESSIONAL GROUP
Entity type:Organization
Organization Name:ZALE PROFESSIONAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HELLA
Authorized Official - Middle Name:ALEJANDRA
Authorized Official - Last Name:MONROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-556-4090
Mailing Address - Street 1:14900 INTERURBAN AVE S
Mailing Address - Street 2:SUITE 271
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-4635
Mailing Address - Country:US
Mailing Address - Phone:206-556-4090
Mailing Address - Fax:206-905-0975
Practice Address - Street 1:14900 INTERURBAN AVE S
Practice Address - Street 2:SUITE 271
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-4635
Practice Address - Country:US
Practice Address - Phone:206-556-4090
Practice Address - Fax:206-905-0975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)