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Individual

LOIS N TALOTTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
1240 RUDDELL RD SE, LACEY, WA 98503-5753
(360) 491-1232
(360) 491-1494
Mailing address
903 ELLINOR AVE, SHELTON, WA 98584-3218
(360) 427-5898

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00008646
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0215737
L & I PROVIDER #
WA
Enumeration date
06/14/2007
Last updated
07/08/2007
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