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Individual

ZACHARY CHASE WHITTAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
605 S COOLIDGE ST, MOSES LAKE, WA 98837-1873
(509) 765-0674
Mailing address
13511 TERRACE CREEK DR APT 200, LOUISVILLE, KY 40245-5845
(801) 367-2465

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE70005087
WA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/06/2025
Last updated
06/27/2025
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