Active NPI
Ephraim Rollolazo Jr.
- Denturist
- Everett, WA
National Provider Identifier
1871040378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Denturist
- License
- DN60142153
- Practice address
- 1111 Pacific Ave Ste a
Everett, WA 98201-4200 - Phone
- (425) 374-8470
- NPI assigned
- Sep 1, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Denturist | 122400000X | DN60142153 | WA | Primary |
Addresses
Primary practice location
1111 Pacific Ave Ste a
Everett, WA 98201-4200
Mailing address
111 Pacific Ave
Suite a
Everett, WA 98201
Phone (425) 374-8470
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN60142153 | WA | MD | Denturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1871040378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 PACIFIC AVE",
"address_2": "SUITE A",
"city": "EVERETT",
"state": "WA",
"postal_code": "98201",
"telephone_number": "425-374-8470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 PACIFIC AVE STE A",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014200",
"telephone_number": "425-374-8470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROLLOLAZO",
"first_name": "EPHRAIM",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-01",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "122400000X",
"taxonomy_group": "",
"desc": "Denturist",
"state": "WA",
"license": "DN60142153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.