Individual
ROMAN ALEJANDRO ELISARRARAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
307 W COTA ST, SHELTON, WA 98584-2265
(360) 205-8001
Mailing address
7621 19TH LN SE APT 310, LACEY, WA 98503-3491
(559) 975-9505
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP70039133
WA
Other
Enumeration date
10/27/2025
Last updated
10/27/2025
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