Provider Demographics
NPI:1992874069
Name:ZINKE, DONALD ALLEN (CRNA)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:ALLEN
Last Name:ZINKE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1506
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-0409
Mailing Address - Country:US
Mailing Address - Phone:360-242-3008
Mailing Address - Fax:360-807-7687
Practice Address - Street 1:115 NEW VIEW CT NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5250
Practice Address - Country:US
Practice Address - Phone:360-252-1642
Practice Address - Fax:360-252-1646
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRNA-743367500000X
MTNUR-APRN-LIC-101031367500000X
AKNURA402367500000X
WAAP60065389367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8878862OtherMEDICARE WA
ID808267100Medicaid
OR500608870Medicaid
AK1579078Medicaid
WA2001129Medicaid