Provider Demographics
NPI:1194406116
Name:ZARA, LINDA SUE (LMT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:SUE
Last Name:ZARA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1870 SPENCER CT
Mailing Address - Street 2:
Mailing Address - City:DUPONT
Mailing Address - State:WA
Mailing Address - Zip Code:98327-8701
Mailing Address - Country:US
Mailing Address - Phone:954-802-8355
Mailing Address - Fax:
Practice Address - Street 1:1870 SPENCER CT
Practice Address - Street 2:
Practice Address - City:DUPONT
Practice Address - State:WA
Practice Address - Zip Code:98327-8701
Practice Address - Country:US
Practice Address - Phone:954-802-8355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMASS.MA61423784225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist