Provider Demographics
NPI:1215266747
Name:VICTOR, KATE ZEBATTO (PA-C, MMS)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:ZEBATTO
Last Name:VICTOR
Suffix:
Gender:F
Credentials:PA-C, MMS
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:BRIELLE
Other - Last Name:ZEBATTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 873010
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98687-3010
Mailing Address - Country:US
Mailing Address - Phone:360-882-2778
Mailing Address - Fax:
Practice Address - Street 1:700 NE 87TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664
Practice Address - Country:US
Practice Address - Phone:360-882-2778
Practice Address - Fax:360-604-1697
Is Sole Proprietor?:No
Enumeration Date:2009-12-11
Last Update Date:2018-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH002998363AS0400X
WAPA60694683363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical