Provider Demographics
NPI:1609990597
Name:WESTENDARP, ZANDER (MD)
Entity type:Individual
Prefix:
First Name:ZANDER
Middle Name:
Last Name:WESTENDARP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FRED
Other - Middle Name:JOSEPH
Other - Last Name:WESTENDARP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1122 E PIKE ST # 911
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-3916
Mailing Address - Country:US
Mailing Address - Phone:206-612-3814
Mailing Address - Fax:603-688-5824
Practice Address - Street 1:1122 E PIKE ST # 911
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-3916
Practice Address - Country:US
Practice Address - Phone:206-612-3814
Practice Address - Fax:603-688-5824
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00036352207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine