Provider Demographics
NPI:1609517754
Name:LOZANO, CATHERINE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:LOZANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 NASS RD
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:WA
Mailing Address - Zip Code:98932-9740
Mailing Address - Country:US
Mailing Address - Phone:509-961-2063
Mailing Address - Fax:
Practice Address - Street 1:1724 WESLEY WAY
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-6001
Practice Address - Country:US
Practice Address - Phone:509-839-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61285966225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist