Provider Demographics
NPI:1497631485
Name:ZAKHARIYA, MARK
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:ZAKHARIYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 NE 157TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-7346
Mailing Address - Country:US
Mailing Address - Phone:971-221-7769
Mailing Address - Fax:
Practice Address - Street 1:1901 NE 162ND AVE STE D112
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-3008
Practice Address - Country:US
Practice Address - Phone:360-803-3546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADENT.DE.70017494122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist