Individual
EPHRAIM ROLLOLAZO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 PACIFIC AVE STE A, EVERETT, WA 98201-4200
(425) 374-8470
Mailing address
111 PACIFIC AVE, SUITE A, EVERETT, WA 98201
(425) 374-8470
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN60142153
WA
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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