Provider Demographics
NPI:1205436433
Name:LALUZ-COGDILL, ROSE SIBONEY
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:SIBONEY
Last Name:LALUZ-COGDILL
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 1:1011 E FILBERT ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-6246
Mailing Address - Country:US
Mailing Address - Phone:206-799-9772
Mailing Address - Fax:
Practice Address - Street 1:1011 E FILBERT ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-6246
Practice Address - Country:US
Practice Address - Phone:206-799-9772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter