Provider Demographics
NPI:1972935153
Name:ZAMORA, PALOMA NOELLE
Entity type:Individual
Prefix:
First Name:PALOMA
Middle Name:NOELLE
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 SHOREWOOD CT
Mailing Address - Street 2:
Mailing Address - City:FOX ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98333-9725
Mailing Address - Country:US
Mailing Address - Phone:206-909-8547
Mailing Address - Fax:
Practice Address - Street 1:7910 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-7031
Practice Address - Country:US
Practice Address - Phone:253-473-3733
Practice Address - Fax:253-473-9517
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00022853174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist