Healthcare Provider Details

I. General information

NPI: 1740142421
Provider Name (Legal Business Name): AIZA TAN LOZADA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4244 AUBURN WAY N
AUBURN WA
98002-1311
US

IV. Provider business mailing address

6400 SOUTHCENTER BLVD
TUKWILA WA
98188-2547
US

V. Phone/Fax

Practice location:
  • Phone: 206-901-2000
  • Fax: 206-901-2010
Mailing address:
  • Phone: 206-901-2000
  • Fax: 206-901-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number280803
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: