Individual
ALFRED S. ROLLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 E WHEELER RD, MOSES LAKE, WA 98837-1820
(509) 766-1301
(509) 766-1306
Mailing address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-6328
(253) 838-6180
(253) 838-6418
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00020773
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0228471
LIWA
WA
05
—
1131200
—
WA
01
—
2655RO
BSWA
WA
01
—
3076RO
BSWA
WA
Enumeration date
05/27/2006
Last updated
12/09/2019
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