Individual
LORETTA M ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3717 GRANDVIEW DR W, UNIVERSITY PLACE, WA 98466-2138
(253) 566-5600
(253) 566-5607
Mailing address
3717 GRANDVIEW DR W, UNIVERSITY PLACE, WA 98466-2138
(253) 566-5600
(253) 566-5607
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
465500G
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200013580A
—
OK
Enumeration date
05/15/2008
Last updated
10/12/2012
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