Basic Information
Provider Information
NPI: 1700294014
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAMBIER
FirstName: ZIADEE
MiddleName: WHIPTAIL
NamePrefix: DR.
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 25608
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841250608
CountryCode: US
TelephoneNumber: 2063204476
FaxNumber: 2065687043
Practice Location
Address1: 1600 E JEFFERSON ST STE A1
Address2:  
City: SEATTLE
State: WA
PostalCode: 981225643
CountryCode: US
TelephoneNumber: 2063202200
FaxNumber: 2063202560
Other Information
ProviderEnumerationDate: 07/30/2014
LastUpdateDate: 08/08/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT60321135WAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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