Individual
DENICE LAZZARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1320 NE 4TH AVE, CAMAS, WA 98607-1432
(503) 415-0782
Mailing address
1320 NE 4TH AVE, CAMAS, WA 98607-1432
(503) 415-0782
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
60700891
WA
251J00000X
Nursing Care Agency
60039723
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60039723
NURSING ASSISTANT CERTIFICATION
WA
01
—
60700891
PHARMACY TECHNICIAN
WA
Enumeration date
11/08/2021
Last updated
11/08/2021
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