Individual
EDGAR ANTONIO ZARAZUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CHW
Contact information
Practice address
102B S CENTER ST, SUBLIMITY, OR 97385-9847
(541) 918-1418
Mailing address
1401 N 10TH AVE, STAYTON, OR 97383-1311
(541) 918-1418
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
THW000107532
OR
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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