Provider Demographics
NPI:1902990757
Name:ZOCCO, LINSEY ELAINE (PA-C)
Entity Type:Individual
Prefix:
First Name:LINSEY
Middle Name:ELAINE
Last Name:ZOCCO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINSEY
Other - Middle Name:ELAINE
Other - Last Name:MOZELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:619 NW 6TH AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3964
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9000 N LOMBARD ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-3006
Practice Address - Country:US
Practice Address - Phone:503-988-5558
Practice Address - Fax:039-885-3055
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3498363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant