Individual
MS. NICOLE MICHELLE LAZARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15401 NE 88TH ST, VANCOUVER, WA 98682-3575
(360) 608-4808
Mailing address
15401 NE 88TH ST, VANCOUVER, WA 98682-3575
(360) 608-4808
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5991
OR
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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