Provider Demographics
NPI:1386709269
Name:ZAHL, CLARESE BEATRICE (LMP)
Entity type:Individual
Prefix:
First Name:CLARESE
Middle Name:BEATRICE
Last Name:ZAHL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:CLARESE
Other - Middle Name:BEATRICE
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:PO BOX 4034
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98194-0034
Mailing Address - Country:US
Mailing Address - Phone:206-618-5114
Mailing Address - Fax:206-577-3803
Practice Address - Street 1:212 ALASKAN WAY S
Practice Address - Street 2:SUITE 105A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-618-5114
Practice Address - Fax:206-577-3803
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00010972225700000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No174400000XOther Service ProvidersSpecialist