Provider Demographics
NPI:1699103036
Name:MCNAIR, ZACHARY DANIEL (PA)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:DANIEL
Last Name:MCNAIR
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:550 GAGE BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-9532
Mailing Address - Country:US
Mailing Address - Phone:509-942-3627
Mailing Address - Fax:509-627-2983
Practice Address - Street 1:4008 W 27TH AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99337
Practice Address - Country:US
Practice Address - Phone:509-942-2355
Practice Address - Fax:509-222-1289
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-22
Last Update Date:2021-06-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPA60696513363A00000X
ORPA165108363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1699103036Medicaid