Organization
PACIFIC NORTHWEST NEUROLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GREGORY ZOLTANI M.D. (OWNER)
(253) 581-8151
Entity
Organization
Contact information
Practice address
215 WILKES ST, STE 202, STEILACOOM, WA 98388-2125
(253) 581-8151
(253) 581-8152
Mailing address
215 WILKES ST, STE 202, STEILACOOM, WA 98388-2125
(253) 581-8151
(253) 581-8152
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00027139
WA
225700000X
Massage Therapist
MA00024442
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0062048
DEPT OF LABOR & INDUSTRIES
WA
05
—
1056415
—
WA
Enumeration date
02/11/2008
Last updated
06/26/2008
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