Basic Information
Provider Information
NPI: 1023456605
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZEITLIN
FirstName: ALLEN
MiddleName: R
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 505 NE 87TH AVENUE
Address2: SUITE 46.5
City: VANCOUVER
State: WA
PostalCode: 98664
CountryCode: US
TelephoneNumber: 3608285396
FaxNumber: 3608285455
Practice Location
Address1: 400 NE MOTHER JOSEPH PL
Address2:  
City: VANCOUVER
State: WA
PostalCode: 986643200
CountryCode: US
TelephoneNumber: 3608285396
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/05/2013
LastUpdateDate: 08/09/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XMD60773413WAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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