Provider Demographics
NPI:1265791636
Name:ROJAS, SUSANNA MARIA (LAC / EAMP)
Entity type:Individual
Prefix:
First Name:SUSANNA
Middle Name:MARIA
Last Name:ROJAS
Suffix:
Gender:F
Credentials:LAC / EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 ROY ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4219
Mailing Address - Country:US
Mailing Address - Phone:206-849-8577
Mailing Address - Fax:
Practice Address - Street 1:557 ROY ST
Practice Address - Street 2:SUITE, 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4219
Practice Address - Country:US
Practice Address - Phone:206-849-8577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-04
Last Update Date:2012-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000470171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist