Individual
MR. LUIS LOZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3801 5TH ST SE STE 110, PUYALLUP, WA 98374-2106
(253) 845-9585
(253) 848-1126
Mailing address
3801 5TH ST SE STE 110, PUYALLUP, WA 98374-2106
(253) 845-9585
(253) 848-1126
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA1003732
WA
363AS0400X
Surgical Physician Assistant
Primary
PA1003732
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2025150
—
WA
01
—
500518
WA LABOR & INDUSTRIES
WA
Enumeration date
01/06/2006
Last updated
11/11/2024
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