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Mary-Colleen D. Zucconi

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

200 NE Mother Joseph Pl Ste 110, Vancouver, WA 98664

PECOS Enrollment

This provider is enrolled in PECOS as MARY COLLEEN ZUCCONI.

Based on the most recent information from CMS, provider Mary-Colleen D. Zucconi is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1194969717
Provider Type
Individual
Full Name
Zucconi, Mary-Colleen D.
Credential
P.A.

Gender
Female
Sole Proprietor
No
Enumeration Date
4/27/2009
Last Updated
8/7/2018

Contact Information

Practice Location

200 NE Mother Joseph Pl Ste 110, Vancouver, WA 98664

(360) 254-6161

(360) 449-1146

Mailing Location

200 NE Mother Joseph Pl Ste 210, Vancouver, WA 98664-3295

(360) 254-6161

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AS0400X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA60404649 Washington
Code 363AS0400X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA152984 Oregon

Mary-Colleen D. Zucconi

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Chan, Vivian

Raftery, Kathleen

Black, Timothy

Boundy, Brian Forrest

Rowney, Rebecca

Ambrose, Nathan

Babcock, Rebecca L

Hermes, Jennifer D

Pirtle, Kyle I.

Province, Joseph