Provider Demographics
NPI:1245756006
Name:LAQILA, APOROSA
Entity Type:Individual
Prefix:
First Name:APOROSA
Middle Name:
Last Name:LAQILA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 38TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-3140
Mailing Address - Country:US
Mailing Address - Phone:206-250-4832
Mailing Address - Fax:
Practice Address - Street 1:12842 NE 102ND PL
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-5248
Practice Address - Country:US
Practice Address - Phone:206-250-4832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAA-3292-WAOtherFIREBIRD INTERNATIONAL INSURANCE GROUP