Provider Demographics
NPI:1700644747
Name:LOZANO, ALONDRA
Entity Type:Individual
Prefix:
First Name:ALONDRA
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 1:840 E PLUM ST
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-1874
Mailing Address - Country:US
Mailing Address - Phone:509-765-9239
Mailing Address - Fax:509-765-1582
Practice Address - Street 1:840 E PLUM ST
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-1874
Practice Address - Country:US
Practice Address - Phone:509-765-9239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist